Chronic fatigue syndrome (CFS), like fibromyalgia and multiple chemical
sensitivity, comprises a number of poorly understood signs and symptoms, and
whether a patient receives the diagnosis for one or another of these symptom
clusters may depend on the specialty of the physician making the diagnosis.1 Patients with CFS also often fulfill case definitions
for these other illnesses.1 This overlap suggests
that these "functional somatic illnesses" may be variants of one another.2 However, this does not necessarily mean that these
syndromes share the same pathobiological processes or causes. For example,
patients with fibromyalgia have been found to have elevated levels of substance
P in spinal fluid3 and reduced pain thresholds,
while patients with CFS have not.4 Similarly,
the fatigue reported by patients with fibromyalgia may be secondary to chronic
sleep disruption because of pain, while fatigue may be primary in CFS.
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