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From: Ron
Date: 01/31/02
Time: 07:20:28 PM -0600
Hi Meow,
You might find this report interesting.
Ron --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- FIBROMYALGIA, MULTIPLE CHEMICAL SENSITIVITIES, CHRONIC FATIGUE SYNDROME.
Report #7198; 8/21/97
Fibromyalgia means that a previously healthy person develops unexplained exhaustion, fatigue and muscle aches and pains that last for more than 6 months, all blood tests are normal and doctors can't find a cause (1).
One recent report shows that a large number of people who were diagnosed as having fibromyalgia really had polymyalgia rheumatica that does have an abnormal blood test (2). The diagnosis of fibromyalgia should be made only after all other causes have been ruled out. Many infections can cause fatigue and muscle pain, such as parvovirus B19, which was reported to be cured with intravenous injections of immunoglobulin (3). The evaluation should include tests for infectious diseases; such as Lyme disease and hepatitis B or C, cytomegalovirus, toxoplasmosis or the helicobacter that causes stomach ulcers;/ autoimmune diseases, such as rheumatoid arthritis, lupus, Crohn's disease or ulcerative colitis;/ hidden cancers such as those of the breast or prostate; hormonal diseases such as low thyroid/ or side effects from a medication or illicit drug. Around 20% will be depressed, but the majority will not have a known cause (4) and doctors often diagnose fibromyalgia, chronic fatigue syndrome or multiple chemical sensitivities (5).
Chronic fatigue means that they are tired, but most also have constipation and diarrhea (6,7). Fibromyalgia usually means that muscle and joint pains are major symptoms, but muscle biopsies are normal (8). Multiple chemical sensitivities means that the patients think that their symptoms are caused by factors in their environment or they consult doctors who think the same thing. These diagnoses mean that untreated, these symptoms will usually continue in adults for the rest of their lives (9,10,11). I have prescribed doxycycline 100 mg twice a day for several months, and sometimes azithromycin 500 mg twice a week, and some get better. However, this treatment is not accepted by most doctors. Please check with your doctor.
I'm Dr. Gabe Mirkin on Fitness.
1) S Wessely. Chronic fatigue syndrome. Journal of the Royal College of Physicians of London. 30: 6 (NOV-DEC 1996):497-504. 2) MA Fitzcharles, JM Esdaile. The overdiagnosis of fibromyalgia syndrome. American Journal of Medicine 103: 1 (JUL 1997):44-50. 3) SK Jacobson, JS Daly, GM Thorne, K Mcintosh. Chronic parvovirus B19 infection resulting in chronic fatigue syndrome: Case history and review. Clinical Infectious Diseases 24: 6 (JUN 1997):1048-1051. Address SK Jacobson, Addenbrookes Hosp, Clin Microbiol & Publ Hlth Lab, Hills Rd, Cambridge CB2 2QQ, England. 4) AC Mawle, R Nisenbaum, JG Dobbins, HE Gary, JA Stewart,M Reyes, L Steele, DS Schmid, WC Reeves. Seroepidemiology of chronic fatigue syndrome: A case-control study. Clinical Infectious Diseases 21: 6 (DEC 1995):1386-1389. None found. 5) D Buchwald. Fibromyalgia and chronic fatigue syndrome: Similarities and differences. Rheumatic Disease Clinics of North America 22: 2:(MAY 1996):219. There are no diagnostic studies or widely accepted pathogenic,explanatory models for either illness. 6) A Sivri, A Cindas, F Dincer, B Sivri. Bowel dysfunction and irritable bowel syndrome in fibromyalgia patients. Clinical Rheumatology 15: 3 (MAY 1996):283-286. 7) JE Gomborone, DA Gorard, PA Dewsnap, GW Libby, MJG Farthing. Prevalence of irritable bowel syndrome in chronic fatigue. Journal of the Royal College of Physicians of London. 30: 6 (NOV-DEC 1996):512-513. 8) RW Simms. Is there muscle pathology in fibromyalgia syndrome? Rheumatic Disease Clinics of North America 22: 2(MAY 1996):245. muscles are not abnormal in the condition. 9) Bombardier CH, Buchwald D. Outcome and prognosis of patients with chronic fatigue vs chronic fatigue syndrome. Arch Intern Med 1995(Oct);155:2105-2110. 10) W Bruckle, J Lautenschlager. Treatment of Fibromyalgia Syndrome. Aktuelle Rheumatologie 20: 1 (JAN 1995):13-19. 11) O Miro, C Font, J Fernandezsola, J Casademont, E Pedrol, JM Grau, A Urbanomarquez. Chronic fatigue syndrome: Clinical and evolutive study of 28 cases. Medicina Clinica 108: 15 (APR 19 1997):561-565. 12) 200/100,000. PH Levine. Epidemiologic advances in chronic fatigue syndrome. Journal of Psychiatric Research 31: 1 (JAN-FEB 1997):7-18. 12) DJ Clauw, M Schmidt, D Radulovic, A Singer, P Katz, J Bresette. The relationship between fibromyalgia and interstitial cystitis. Journal of Psychiatric Research 31: 1 (JAN-FEB 1997):125-131. similar complaints.
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Transcripts of segments of The Dr. Gabe Mirkin Show are provided as a service to listeners at no charge. Dr. Mirkin's opinions and the references cited are for information only, and are not intended to diagnose or prescribe. For your specific diagnosis and treatment, consult your doctor or health care provider.
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