Fibromyalgia (FM) is a chronic illness characterised by a combination of chronic widespread
musculoskeletal pain and tenderness, accompanied by varying degrees of other symptoms, including
fatigue, sleep disturbance, musculoskeletal pain an d stiffness, cognitive dysfunction and high levels
Of distress. There are often associated conditions such as headache, restless legs syndrome, irritable
bowel syndrome, multiple chemical sensitivities, anxiety and depression. The criteria for diagnosing
FM in recent years encompasses the five key areas that reflect the entire syndrome (previously
diagnosed by tender points at specific sites), which includes scores on; pain, fatigue, waking
unrefreshed, cognitive symptoms and somatic symptoms.

The criteria for both CFS and fibromyalgia (FM) share a significant cross-over; however CFS is dominated by fatigue with brain fog, pain and immune dysfunction as secondary presentations. In FM pain is the primary symptom with fatigue, mood disroders and other neural symptoms being Concomitant. Both CFS and FM share common pathophysiology of mitochondrial dysfunction and oxidative stress, and the difference in symptoms appears to relate to the degree and location of ischaemia (determining how much muscle pain is present), the cortisol and catecholamine status (determining the level of fatigue and other consequences) and the particular pattern of drivers and concomitants; such as chronic infection, insulin resistance or patterns of stress exposure.

All common drivers need to be screened including dysbiosis/leaky gut, infection, stress, toxicity,nutritional deficiency, gluten disorders, thyroid function and obesity and/or insulin resistance that May all contribute to this multifactorial pathology.

Aetiology / Risk Factors:
Chronic fatigue syndrome may be preceded by or associated with:
• acute viral illness,
• chronic health problems,
• emotional factors (anxiety, depression),
• micronutrient deficiencies
• environmental pollutants and contaminants
• general poor health and compromised immunity

Symptoms & Signs:
• Sudden onset of severe fatigue, developing over a few hours to a few days and often after an acute viral illness and persists for at least six months.
• Low-grade fever and chills
• Sore throat
• Lymphadenopathy
• Myalgias and arthralgias
• Headaches
• Sleep disturbances
• Decreased ability to concentrate or remember
• Allergies
• General muscle weakness