What's the Difference?
Some doctors treat fibromyalgia (FMS) or chronic fatigue syndrome (CFS or ME/CFS) separately, while others think they are actually the same thing – or at least, variations of the same condition. According to the Arthritis Foundation, research shows that 50 to 70 percent of people with one diagnosis also fit the criteria for the other.
Similarities Between Fibromyalgia & Chronic Fatigue Syndrome
FMS and CFS are known to have a host of symptoms in common. They include:
- Pain
- Fatigue
- Sleep disorders
- Irritable bowel syndrome symptoms
- Chronic headaches
- Association with Temporomandibular Joint Syndrome (TMJ)
- Cognitive or memory impairment
- Dizziness
- Impaired coordination
Differences Between Fibromyalgia & Chronic Fatigue Syndrome
One key difference, when it comes to a diagnosis, is which symptom is worst – pain or fatigue. The diagnosis could also be influenced by whether your doctor is more familiar with the American College of Rheumatology's criteria for FMS or the CDC's guidelines for ME/CFS.
However, experts have found some significant differences. ME/CFS tends to begin after flu-like symptoms and may be linked to a virus. ME/CFS patients often have high levels of a cellular antiviral enzyme called RNase L, while the level is normal in FMS patients. Also, ME/CFS diagnostic criteria include low-grade fever and sore throat, while FMS criteria do not. Meanwhile, the onset of FMS frequently is traced to a physical or emotional trauma. The pain of FMS gets better with heat and massage, while the pain of ME/CFS does not. Further, people with FMS have tender points and abnormal levels of a cellular chemical called substance P (which transmits pain signals), and this level appears to be normal in those with ME/CFS.
Why it Matters
In the end, does it really matter? Some used to say it didn't.
Now, however, the drugs Lyrica (pregabalin) and Cymbalta (duloxetine) are approved for fibromyalgia. The FDA also is considering a New Drug Appliation for milnacipran as a fibromyalgia treatment, as well as Ampligen (poly I: poly C12U) for treating chronic fatigue syndrome.
Lyrica, Cymbalta and milnacipran all boost certain neurotransmitters, which may be normal or even already elevated in people with ME/CFS. Ampligen modifies the immune system, and researchers aren't yet sure what, if any, immune abnormalities people with FMS may have. It could be dangerous to take these drugs if you don't have the problems they're intended to correct.
The best course of action is to talk to your doctor about both conditions and make sure you've done all you can to solidify your diagnosis.
Source:
Arthritis Foundation "What’s in a Name: Fibro vs. CFS"
