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[[Myalgic Encephalomyelitis]]/[[Chronic Fatigue Syndrome]] (ME/CFS) | '''Primer for family, friends and care providers''' is for those who know or care for someone with [[Myalgic Encephalomyelitis]]/[[Chronic Fatigue Syndrome]] (ME/CFS), a complicated and life-altering systemic, biological neuro-immune disease.<ref>[http://www.openmedicinefoundation.org/what-is-mecfs/ What is ME/CFS? - Open Medicine Foundation]</ref> Patient care and severity of the disease is poorly understood due to decades of research neglect and a lack of clinical care worldwide.<ref>[http://healthaffairs.org/blog/2016/02/04/reexamining-chronic-fatigue-syndrome-research-and-treatment-policy/ Reexamining Chronic Fatigue Syndrome Research And Treatment Policy - Health Affairs Blog By: David Tuller]</ref><ref>[http://www.meaction.net/2017/01/22/funding-for-me-research-centers-announced-falls-way-short/ Funding for ME Research Centers Announced Falls Way Short -#MEAction]</ref> | ||
[[Chronic Fatigue Syndrome]] (CFS) is not [[Chronic Fatigue]]. It is not a psychiatric illness or "illness beliefs" which is the widely accepted hypothesis in the UK.<ref>[http://www.25megroup.org/infomedical_MWilliams_submission_DSM.html Submission re: DSM-V and ME/CFS 25% ME Group]</ref><ref>[https://www.nytimes.com/2017/03/18/opinion/sunday/getting-it-wrong-on-chronic-fatigue-syndrome.html?smid=tw-share Getting it Wrong on Chronic Fatigue Syndrome - New York Times By: Julie Rehmeyer and David Tuller]</ref> [[Exercise]] and exertion make patients worse triggering a myriad of chronic and disabling symptoms.<ref>[https://directorsblog.nih.gov/2017/03/21/moving-toward-answers-in-mecfs/ Moving Toward Answers in ME/CFS - NIH Director's Blog By | [[Chronic Fatigue Syndrome]] (CFS) is not [[Chronic Fatigue]]. It is not a psychiatric illness or "illness beliefs" which is the widely accepted hypothesis in the UK.<ref>[http://www.25megroup.org/infomedical_MWilliams_submission_DSM.html Submission re: DSM-V and ME/CFS 25% ME Group]</ref><ref>[https://www.nytimes.com/2017/03/18/opinion/sunday/getting-it-wrong-on-chronic-fatigue-syndrome.html?smid=tw-share Getting it Wrong on Chronic Fatigue Syndrome - New York Times By: Julie Rehmeyer and David Tuller]</ref> This has led to the use of [[Graded exercise therapy]] (GET), which can severely injure persons with [[ME/CFS]], and [[Cognitive behavioral therapy]] (CBT) that cannot treat a physiological disease. [[Exercise]] and exertion make patients worse triggering a myriad of chronic and disabling symptoms.<ref>[https://directorsblog.nih.gov/2017/03/21/moving-toward-answers-in-mecfs/ Moving Toward Answers in ME/CFS - NIH Director's Blog By Dr. Walter Koroshetz and Dr. Francis Collins]</ref><ref>[http://www.openmedicinefoundation.org/what-is-mecfs/ What is ME/CFS? - Open Medicine Foundation]</ref><ref>[http://solvecfs.org/what-is-mecfs/ Get the Facts about ME/CFS]</ref> The hallmark symptom is [[Post-exertional malaise]] (PEM). | ||
ME/CFS affects up to 2.5 million Americans with estimates of 17 million worldwide.<ref>[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_KeyFacts.pdf ''Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Key Facts - Feb 2015'']</ref><ref>[http://www.meresearch.org.uk/news/how-many-people-have-mecfs/ How many people have ME/CFS - ME Research UK]</ref> "A quarter of all patients are entirely house-, bed- or wheelchair bound. One in ten dies prematurely due to major organ failure, [[cancer]], heart disease or [[suicide]]."<ref>[http://sacfs.asn.au/news/2013/10/10_08_fdas_voice_of_the_patient_report.htm FDA's Voice of the Patient Report on Chronic Fatigue Syndrome Reveals Disease Impact and Areas for Progress - ME/CFS Australia (SA) Inc - By: Pandora.org]</ref> In 2012, the [[Centers for Disease Control & Prevention]] (CDC) estimated less than 20% of Americans that have CFS were diagnosed.<ref>[https://www.cdc.gov/cfs/diagnosis/index.html Chronic Fatigue Syndrome - Diagnostic Challenges - CDC - 2012]</ref> Diagnosis can take years with a patient seeing several doctors before receiving a diagnosis. A 2008 [[ProHealth]] survey of 1,210 ME/CFS patients showed "29% had been ill from 6 to 20-plus years before being diagnosed."<ref>[http://www.prohealth.com/library/showarticle.cfm?libid=13672 A Profile of ME/CFS Patients - How Many Years and How Many Doctors?]</ref> | |||
Diagnosing is difficult as there is no [[biomarker]] and there are numerous definitions and criteria that have been developed and utilized over the decades. ''See:'' [ | Diagnosing is difficult as there is no [[biomarker]] and there are numerous definitions and criteria that have been developed and utilized over the decades. ''See:'' [[Definitions of ME and CFS]]. | ||
== Disease onset and | == Disease onset and course of illness== | ||
The disease [[ME/CFS]] is diagnosed when a person does not recover from a flu-like illness, [[EBV]], [[Mononucleosis]], [[HHV]], [[Q fever]], [[Virus]] or other infections and meets one or more diagnostic criteria for either ME, CFS or ME/CFS.<ref>[https://www.nap.edu/read/19012/chapter/7#157 IOM Report - INFECTION]</ref><ref>[http://www.cortjohnson.org/blog/2014/01/09/lipkin-study-vagus-nerve-hhv-6-loomis-hhv-6-foundation/ The Lipkin Study, The Vagus Nerve Infection Hypothesis and HHV-6: Kristin Loomis of the HHV-6 Foundation Talks – Pt. I - Health Rising - By: Cort Johnson - June 2014]</ref><ref>[http://me-pedia.org/wiki/Definitions_of_ME_and_CFS Definitions of ME and CFS - MEpedia]</ref> Patient health is never the same and they experience numerous symptoms and disease severity which fluctuate day to day, week to week, month to month, year to year and decade to decade as well as varying symptoms and disease severity among patients.<ref>[http://www.meassociation.org.uk/about/the-symptoms-and-diagnosis-of-mecfs/ Symptoms and diagnosis of ME/CFS - ME Association]</ref><ref>[http://www.webmd.com/chronic-fatigue-syndrome/chronic-fatigue-syndrome-symptoms Chronic Fatigue Syndrome - Symptoms - Web MD]</ref><ref>[http://phoenixrising.me/mecfs-basics/chronic-fatigue-syndrome-mecfs-facts-chronic-fatigue-syndrome-is-2 Facts (ME/CFS) Severity]</ref> | The disease [[ME/CFS]] is diagnosed when a person does not recover from a flu-like illness, [[EBV]], [[Mononucleosis]], [[HHV]], [[Q fever]], [[Virus]] or other infections and meets one or more diagnostic criteria for either ME, CFS or ME/CFS.<ref>[https://www.nap.edu/read/19012/chapter/7#157 IOM Report - INFECTION]</ref><ref>[http://www.cortjohnson.org/blog/2014/01/09/lipkin-study-vagus-nerve-hhv-6-loomis-hhv-6-foundation/ The Lipkin Study, The Vagus Nerve Infection Hypothesis and HHV-6: Kristin Loomis of the HHV-6 Foundation Talks – Pt. I - Health Rising - By: Cort Johnson - June 2014]</ref><ref>[http://me-pedia.org/wiki/Definitions_of_ME_and_CFS Definitions of ME and CFS - MEpedia]</ref> "Occasionally, ME/CFS has been triggered by environmental toxins, the receipt of an immunizing injection, or surviving a major trauma."<ref>[https://www.masscfids.org/images/pdf/Primer_2014.pdf Chronic Fatigue Syndrome Myalgic Encephalomyelitis - Primer for Clinical Practitioners - 2014 Edition - Massachusettes CFIDS/FM Assoc]</ref> Patient health is never the same and they experience numerous symptoms and disease severity which fluctuate day to day, week to week, month to month, year to year and decade to decade as well as varying symptoms and disease severity among patients.<ref>[http://www.meassociation.org.uk/about/the-symptoms-and-diagnosis-of-mecfs/ Symptoms and diagnosis of ME/CFS - ME Association]</ref><ref>[http://www.webmd.com/chronic-fatigue-syndrome/chronic-fatigue-syndrome-symptoms Chronic Fatigue Syndrome - Symptoms - Web MD]</ref><ref>[http://phoenixrising.me/mecfs-basics/chronic-fatigue-syndrome-mecfs-facts-chronic-fatigue-syndrome-is-2 Facts (ME/CFS) Severity]</ref> | ||
==== Pediatric ME/CFS ==== | ==== Pediatric ME/CFS ==== | ||
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==== Female to male ratio ==== | ==== Female to male ratio ==== | ||
Like many auto-immune and neuro-immune diseases where mostly women are afflicted,<ref>[http://www.rightdiagnosis.com/artic/fact_sheet_autoimmune_disease_in_women_nwhic.htm Fact Sheet Autoimmune Disease in Women: NWHIC - Right Diagnosis - Aug 2015]</ref> the ME/CFS female/male patient ratio is 6:1.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/21244747 Chronic fatigue syndrome/myalgic encephalomyelitis: an update. - PUBMed Dec. 2010]</ref> [[Fibromyalgia]] has a F/M 7:1 ratio and some ME/CFS patients have this additional diagnosis.<ref>[http://www.cdc.gov/arthritis/basics/fibromyalgia.htm Fibromyalgia - CDC]</ref><ref>[http://solvecfs.org/what-is-mecfs/ What Is ME/CFS (Fibromyalgia) Solve ME/CFS Initiative]</ref> | Like many auto-immune and neuro-immune diseases where mostly women are afflicted,<ref>[http://www.rightdiagnosis.com/artic/fact_sheet_autoimmune_disease_in_women_nwhic.htm Fact Sheet Autoimmune Disease in Women: NWHIC - Right Diagnosis - Aug 2015]</ref> the ME/CFS female/male patient ratio is 6:1.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/21244747 Chronic fatigue syndrome/myalgic encephalomyelitis: an update. - PUBMed Dec. 2010]</ref> [[Fibromyalgia]] has a F/M 7:1 ratio<ref>[http://emedicine.medscape.com/article/329838-overview#a5 Fibromyalgia:Epidemiology - Medscape]</ref> and some ME/CFS patients have this additional diagnosis.<ref>[http://www.cdc.gov/arthritis/basics/fibromyalgia.htm Fibromyalgia - CDC]</ref><ref>[http://solvecfs.org/what-is-mecfs/ What Is ME/CFS (Fibromyalgia) Solve ME/CFS Initiative]</ref> | ||
== Recommended viewing == | == Recommended viewing == | ||
==== Documentary ==== | ==== Documentary ==== | ||
*[[Forgotten Plague]] is a US documentary about [[Ryan Prior]], an afflicted journalist who investigates the disease and its history and why the [[CDC]] has left millions | *[[Forgotten Plague]] is a US documentary about [[Ryan Prior]], an afflicted journalist who investigates the disease and its history and why the [[CDC]] has left millions sidelined from life; available for [http://www.forgottenplague.com/ streaming and DVD ''purchase'']. (2015) | ||
*[[Unrest]] is a US documentary film that will air on PBS's Independent Lens in 2018. [[Jennifer Brea]], a person with [[ME]], directs. (2017) | *[[Unrest]] is a US documentary film that will air on PBS's Independent Lens in 2018. [[Jennifer Brea]], a person with [[ME]], directs. (2017) | ||
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*[http://www.ted.com/talks/jen_brea_what_happens_when_you_have_a_disease_doctors_can_t_diagnose Video: What happens when you have a disease doctors can't diagnose] Jennifer Brea gives a [https://en.wikipedia.org/wiki/TED_(conference) TED Talk] to explain her psychiatric misdiagnosis of [https://en.wikipedia.org/wiki/Conversion_disorder Conversion disorder], her correct diagnosis of [[Myalgic encephalomyelitis]], the disease impact on her life and how women are more often to receive a psychiatric misdiagnosis for a biologic disease. (2016) | *[http://www.ted.com/talks/jen_brea_what_happens_when_you_have_a_disease_doctors_can_t_diagnose Video: What happens when you have a disease doctors can't diagnose] Jennifer Brea gives a [https://en.wikipedia.org/wiki/TED_(conference) TED Talk] to explain her psychiatric misdiagnosis of [https://en.wikipedia.org/wiki/Conversion_disorder Conversion disorder], her correct diagnosis of [[Myalgic encephalomyelitis]], the disease impact on her life and how women are more often to receive a psychiatric misdiagnosis for a biologic disease. (2016) | ||
*Jennifer Brea is interviewed for the upcoming BRIC Flix on her ME/CFS disease experience and her 2017 documentary film [[Canary in a Coal Mine]] (now | *Jennifer Brea is interviewed for the upcoming BRIC Flix on her ME/CFS disease experience and her 2017 documentary film [[Canary in a Coal Mine]] (now titled Unrest) at [https://www.youtube.com/watch?v=zeIefNymFuw 5:30 and 10:20 - Youtube] (2016) | ||
== Recommended reading == | == Recommended reading == | ||
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:[[National Institutes of Health]] (NIH) | :[[National Institutes of Health]] (NIH) | ||
:*[[Moving Toward Answers in ME/CFS | :*[[Moving Toward Answers in ME/CFS - NIH Director's Blog (2017)]] | ||
:[[Institute of Medicine]] (IOM) | :[[Institute of Medicine]] (IOM) | ||
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:[[Solve ME/CFS]] | :[[Solve ME/CFS]] | ||
:*[https://drive.google.com/file/d/0B6UlcglLsyp7WkgxbmdaWXVhbVU/view What, Exactly, is a Biomarker Anyway? And Why Don't We Have One for ME/CFS?] (2017) | |||
:*[http://solvecfs.org/what-is-mecfs/ Get the Facts about ME/CFS] (2016) | :*[http://solvecfs.org/what-is-mecfs/ Get the Facts about ME/CFS] (2016) | ||
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==== Other reading==== | ==== Other reading==== | ||
:*[http://thirdage.com/what-do-you-do-when-a-loved-one-becomes-chronically-ill/ What Do You Do When a Loved One Becomes Chronically Ill?] By | :*[http://thirdage.com/what-do-you-do-when-a-loved-one-becomes-chronically-ill/ What Do You Do When a Loved One Becomes Chronically Ill?] By Suzan Jackson | ||
== Research avenues == | == Research avenues == | ||
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== Notable studies == | == Notable studies == | ||
*[[Metabolic features of chronic fatigue syndrome]] (2016) | *[[Metabolic features of chronic fatigue syndrome]] (2016) | ||
*[[Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder]] With brain images. | *[[Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder - New York Times: Well (2014)]] With brain images. | ||
*[[Cytokine#Notable_Studies|Cytokine ("Notable studies")]] | *[[Cytokine#Notable_Studies|Cytokine ("Notable studies")]] | ||
== Learn more == | == Learn more == | ||
*[[Biopsychosocial model]] (BPS model) | |||
*[[Primer for patients]] | |||
*[[Primer for the public]] | |||
*[http://me-pedia.org/wiki/Category:Patient_groups_by_country Patient groups by country] | *[http://me-pedia.org/wiki/Category:Patient_groups_by_country Patient groups by country] | ||
== See also == | == See also == |
Revision as of 14:13, June 25, 2017
Primer for family, friends and care providers is for those who know or care for someone with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a complicated and life-altering systemic, biological neuro-immune disease.[1] Patient care and severity of the disease is poorly understood due to decades of research neglect and a lack of clinical care worldwide.[2][3]
Chronic Fatigue Syndrome (CFS) is not Chronic Fatigue. It is not a psychiatric illness or "illness beliefs" which is the widely accepted hypothesis in the UK.[4][5] This has led to the use of Graded exercise therapy (GET), which can severely injure persons with ME/CFS, and Cognitive behavioral therapy (CBT) that cannot treat a physiological disease. Exercise and exertion make patients worse triggering a myriad of chronic and disabling symptoms.[6][7][8] The hallmark symptom is Post-exertional malaise (PEM).
ME/CFS affects up to 2.5 million Americans with estimates of 17 million worldwide.[9][10] "A quarter of all patients are entirely house-, bed- or wheelchair bound. One in ten dies prematurely due to major organ failure, cancer, heart disease or suicide."[11] In 2012, the Centers for Disease Control & Prevention (CDC) estimated less than 20% of Americans that have CFS were diagnosed.[12] Diagnosis can take years with a patient seeing several doctors before receiving a diagnosis. A 2008 ProHealth survey of 1,210 ME/CFS patients showed "29% had been ill from 6 to 20-plus years before being diagnosed."[13]
Diagnosing is difficult as there is no biomarker and there are numerous definitions and criteria that have been developed and utilized over the decades. See: Definitions of ME and CFS.
Disease onset and course of illness[edit | edit source]
The disease ME/CFS is diagnosed when a person does not recover from a flu-like illness, EBV, Mononucleosis, HHV, Q fever, Virus or other infections and meets one or more diagnostic criteria for either ME, CFS or ME/CFS.[14][15][16] "Occasionally, ME/CFS has been triggered by environmental toxins, the receipt of an immunizing injection, or surviving a major trauma."[17] Patient health is never the same and they experience numerous symptoms and disease severity which fluctuate day to day, week to week, month to month, year to year and decade to decade as well as varying symptoms and disease severity among patients.[18][19][20]
Pediatric ME/CFS[edit | edit source]
Children are also afflicted with ME/CFS.[21][22] See: Pediatric.
Prognosis[edit | edit source]
Prognosis for ME/CFS is generally poor. See: Prognosis
Female to male ratio[edit | edit source]
Like many auto-immune and neuro-immune diseases where mostly women are afflicted,[23] the ME/CFS female/male patient ratio is 6:1.[24] Fibromyalgia has a F/M 7:1 ratio[25] and some ME/CFS patients have this additional diagnosis.[26][27]
Recommended viewing[edit | edit source]
Documentary[edit | edit source]
- Forgotten Plague is a US documentary about Ryan Prior, an afflicted journalist who investigates the disease and its history and why the CDC has left millions sidelined from life; available for streaming and DVD purchase. (2015)
- Unrest is a US documentary film that will air on PBS's Independent Lens in 2018. Jennifer Brea, a person with ME, directs. (2017)
Mini-doc & Short film[edit | edit source]
- Invisible Illness - Stories of Chronic Fatigue Syndrome is a Palo Alto Online, US Mini-Doc on Youtube. It documents 3 people with CFS suffering from the same disease in varying degrees of illness. (2015)
- The Last Great Medical Cover Up is a UK short Film on Vimeo with several patient interviews. (2015)
Shorts[edit | edit source]
- #MillionsMissing provides a <5 min. short UK Video 'What Is M.E.?' Discusses the disease impact on several people with ME. (2016)
News media[edit | edit source]
- Chronic Fatigue: Missing Millions (Carte Blanche DSTV) TV report, South Africa (2017)
Talks and interviews[edit | edit source]
- Video: What happens when you have a disease doctors can't diagnose Jennifer Brea gives a TED Talk to explain her psychiatric misdiagnosis of Conversion disorder, her correct diagnosis of Myalgic encephalomyelitis, the disease impact on her life and how women are more often to receive a psychiatric misdiagnosis for a biologic disease. (2016)
- Jennifer Brea is interviewed for the upcoming BRIC Flix on her ME/CFS disease experience and her 2017 documentary film Canary in a Coal Mine (now titled Unrest) at 5:30 and 10:20 - Youtube (2016)
Recommended reading[edit | edit source]
Government health organizations[edit | edit source]
- USA
- Centers for Disease Control (CDC)
- Factsheets - Pediatric Factsheets for Healthcare Professionals, Parents, and Education Professionals. (2014)
- Institute of Medicine (IOM)
- Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Redefining an Illness Report Brief on the Institute of Medicine report. (2015)
ME/CFS research foundations[edit | edit source]
- UK
- USA
ME/CFS organizations[edit | edit source]
- Australia
- UK
- Tymes Trust (Pediatric)
- Get the Facts about ME/CFS (2016)
- What is ME/CFS? (2013)
- International
- MEAction
- Reports and Fact Sheets (2015)
Other organizations[edit | edit source]
Other reading[edit | edit source]
- What Do You Do When a Loved One Becomes Chronically Ill? By Suzan Jackson
Research avenues[edit | edit source]
- Dr. Anthony Komaroff Webinar Hot Areas in ME/CFS Research (2016)
- Beyond the Data – Chronic Fatigue Syndrome: Advancing Research and Clinical Education CDC Video (2016)
Notable studies[edit | edit source]
- Metabolic features of chronic fatigue syndrome (2016)
- Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder - New York Times: Well (2014) With brain images.
- Cytokine ("Notable studies")
Learn more[edit | edit source]
- Biopsychosocial model (BPS model)
- Primer for patients
- Primer for the public
- Patient groups by country
See also[edit | edit source]
- Twitter #mecfs
- VOAT Chronic Fatigue Syndrome Subverse Articles, research, videos and more.
References[edit | edit source]
- ↑ What is ME/CFS? - Open Medicine Foundation
- ↑ Reexamining Chronic Fatigue Syndrome Research And Treatment Policy - Health Affairs Blog By: David Tuller
- ↑ Funding for ME Research Centers Announced Falls Way Short -#MEAction
- ↑ Submission re: DSM-V and ME/CFS 25% ME Group
- ↑ Getting it Wrong on Chronic Fatigue Syndrome - New York Times By: Julie Rehmeyer and David Tuller
- ↑ Moving Toward Answers in ME/CFS - NIH Director's Blog By Dr. Walter Koroshetz and Dr. Francis Collins
- ↑ What is ME/CFS? - Open Medicine Foundation
- ↑ Get the Facts about ME/CFS
- ↑ Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Key Facts - Feb 2015
- ↑ How many people have ME/CFS - ME Research UK
- ↑ FDA's Voice of the Patient Report on Chronic Fatigue Syndrome Reveals Disease Impact and Areas for Progress - ME/CFS Australia (SA) Inc - By: Pandora.org
- ↑ Chronic Fatigue Syndrome - Diagnostic Challenges - CDC - 2012
- ↑ A Profile of ME/CFS Patients - How Many Years and How Many Doctors?
- ↑ IOM Report - INFECTION
- ↑ The Lipkin Study, The Vagus Nerve Infection Hypothesis and HHV-6: Kristin Loomis of the HHV-6 Foundation Talks – Pt. I - Health Rising - By: Cort Johnson - June 2014
- ↑ Definitions of ME and CFS - MEpedia
- ↑ Chronic Fatigue Syndrome Myalgic Encephalomyelitis - Primer for Clinical Practitioners - 2014 Edition - Massachusettes CFIDS/FM Assoc
- ↑ Symptoms and diagnosis of ME/CFS - ME Association
- ↑ Chronic Fatigue Syndrome - Symptoms - Web MD
- ↑ Facts (ME/CFS) Severity
- ↑ ME/CFS in Children - by David S. Bell, MD - Open Medicine Foundation
- ↑ Pediatric ME/CFS - Massachusetts CFIDS/ME FM Association
- ↑ Fact Sheet Autoimmune Disease in Women: NWHIC - Right Diagnosis - Aug 2015
- ↑ Chronic fatigue syndrome/myalgic encephalomyelitis: an update. - PUBMed Dec. 2010
- ↑ Fibromyalgia:Epidemiology - Medscape
- ↑ Fibromyalgia - CDC
- ↑ What Is ME/CFS (Fibromyalgia) Solve ME/CFS Initiative