September 1997 -- First, let's define the three diseases briefly and discuss how they're diagnosed.
While the constellation of
symptoms can be similar, the primary complaint in Chronic Fatigue Syndrome (CFS) is
the unrelenting fatigue. Even the smallest physical exertion can put the sufferer in bed for days.
There is no official clinical test to make a firm diagnosis of CFS. Instead, doctors typically rule
out other underlying illnesses before making a CFS diagnosis.
(FMS), an arthritis-related condition, the primary complaint is the pain, a round-the-clock
pain that rarely goes away. FMS can be diagnosed via a detailed 18-point "tender point"
With Hashimoto's Autoimmune Thyroid disease ( HAIT), the thyroid fails to produce
sufficient thyroid hormone to regulate metabolism. Symptoms of the resulting underactive
thyroid usually include some complaint of fatigue or depression, but may include a host of other
symptoms, including or muscular and joint pain, excessive weight gain, hair loss, dry and coarse,
skin, menstrual irregularities, infertility and recurrent miscarriage, low blood pressure, high
cholesterol and others. Diagnosis is most often by the sensitive thyroid stimulating hormone
(TSH) test, but some doctors also use the thyrotropin releasing hormone (TRH) test or tests for
Why is Diagnosis Difficult?
CFS, FMS and HAIT patients often visit their doctors complaining of a host of symptoms. (See
sidebar.) Since symptoms are similar, there is a risk of misdiagnosis. Some doctors still fail to
even acknowledge the existence of CFS and FMS.
And while medical tests can, in most cases,
easily test for thyroid problems, many doctors still fail to diagnose the obvious signs of HAIT, or
rely only on one test to diagnose the condition. Commonly, HAIT is also often misdiagnosed as
depression, stress, or "female" hormonal problems such as premenstrual syndrome, post-partum
depression or menopause symptoms, which are often labels applied to CFS and FMS sufferers as
Various Symptoms Seen in CFS, FMS & HAIT
Feeling run down, sluggish
Muscle cramps and pains
Unexplained or excessive weight gain
Inability to lose weight
Irritable bowel syndrome
Headaches and migraines
Low exercise tolerance
Cold in extremities
Dry, coarse and/or itchy skin
Dry, coarse and/or thinning hair
Increased menstrual flow
More frequent periods
Low grade fever
Slowed thinking, mental fog
Eczema, acne, rashes
Swelling and fluid retention
Carpal tunnel syndrome
Numbness and tingling in extremities
Reduced sexual interest and ability
More frequent infections
Worsening of allergies and asthmatic reactions
Difficulty getting a full breath
More frequent yeast infections
Puffiness around the eyes
Low blood pressure
Neck pain/neck aches
Who Gets CFS, FMS and HAIT?
The majority of diagnosed cases of CFS occur in women, most of whom are 25 to 45 years old.
FMS strikes mostly women between the ages of 20 and 50. And HAIT is known to affect women
seven times more often than men, often women in the same age range. Researchers speculate that
the same autoimmune mechanisms may be at work, and hormonal relationships may explain the
higher incidence in women.
Are CFS, FMS and HAIT All Autoimmune Diseases?
While HAIT is known to be an autoimmune illness, researchers are beginning to believe that
there is a strong autoimmune component to CFS and FMS as well. Ultimately, the three diseases may,
be found to be varying manifestations of the same underlying autoimmune problems. The autoimmune connection that underlies these three conditions is discussed at length in the book Living Well With Autoimmune Disease.
Research reported in the Journal of Clinical Investigation indicates that there is a clear
autoimmune component in chronic fatigue syndrome, and that approximately 52% of chronic
fatigue syndrome patients develop autoantibodies indicative of autoimmune reactions.
German researchers also suggested a relationship between CFS and autoimmune disease,
including autoimmune thyroid antibodies. In the a 1994 article in the German medical journal
Wien Med Wochenschr, ([link
pt=r]Chronic fatigue syndrome: immune dysfunction, role of pathogens
toxic agents and neurological and cardiac changes), a study of 375 patients with chronic
fatigue syndrome showed an increased occurrence of autoantibodies in the
CFS-patients...especially microsomal thyroid antibodies. According to the researchers, this
suggests that "CFS is associated with or the beginning of manifest autoimmune disease."