Most doctors who study both Chronic Fatigue Syndrome and Fibromyalgia find the two disorders so similar that we consider them "identical" for most intents and purposes. However, there are some subtle differences. Chronic Fatigue Syndrome (CFS) is most likely triggered by an infectious or flu-like illness, whereas a number of Fibromyalgia cases are triggered by minor injury or trauma. 

THE SCIENCE:​

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CFS is characterized biochemically by elevated levels of an anti-viral enzymes, whereas Fibromyalgia is unique in having excess Substance P (which triggers pain in nerves) in the bodily fluids. Profound exertional fatigue, post-exertional malaise, deep myalgias, sleep disruption, cognitive dysfunction, and autonomic abnormalities are common to both. 

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Persons with Fibromyalgia tend to improve with low level, slowly progressive exercise, whereas those with CFS are more likely to flare or relapse with even minimal activity. 

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There are some abnormalities that are common too. For instance, close to 100% of individuals with these syndromes have low thyroid gland function. However, standard blood tests for TSH (Thyroid Stimulating Hormone) is usually not elevated in these individuals due to pituitary dysfunction. Many CFS and Fibromyalgia sufferers will also have high levels of the anti-thyroid antibodies or reverse T3, which is usually not measured on standard blood tests. In addition, the majority of individuals can also have a thyroid receptor resistance that is not detected on the blood tests. Consequently, thyroid treatment, especially with timed release T3, is effective for many patients. T4 preparations (inactive thyroid), such as Synthroid and Levoxyl, usually do not work well for these conditions.

There are currently no FDA-approved prescription medications for use in treating CFS. There are, however, a number of medications that are used to treat the various symptoms of CFS. Many are recommended for the effects that may be unrelated to their primary use. These may include antidepressants, antifungals, antihistamines, antivirals, CNS depressants (or stimulants), immunoglobulins, cardiac medications, anti-inflammatories, anticonvulsants, corticoids and expectorants.

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A report in the Annual Review of Medicine stated that Chronic Fatigue Syndrome "is an illness characterized by activation of the immune system, various abnormalities of several hypothalamic-pituitary axes, and reactivation of certain infectious agents" (Komaroff et al. 1998). This suggests that an individual with CFS should follow a regimen that involves protecting and enhancing the immune system with proper nutritional supplements, proteins, and hormones. Free radicals play a role in causing damage to the immune system.

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CFS and Fibromyalgia are serious and debilitating illnesses that are often dismissed as psychosomatic. Actually, a disturbed immune system may play a central role in their development, as well as the environment, diet, viral or fungal infection; all aspects of a human being including the physical body, emotions and thoughts.

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It can occur at any age and presents in childhood as a loss of concentration, often accompanied by colds or rhinitis. It may fluctuate and can be more severe on certain days.