Why is Chronic Fatigue Underdiagnosed?

The Mayo Clinic’s Fibromyalgia and Chronic Fatigue Clinic recently reported online that men are underdiagnosed with fibromyalgia and chronic fatigue. This data is from Olmsted County in Rochester, Minnesota. This reminds me of a somewhat funny story told by a researcher at the Mayo clinic at a meeting I attended several years ago. The professor noted that one of the problems of doing research in his community around the Mayo Clinic was that the Midwestern men, many with stoic personalities, were very reluctant to complain about anything. These men had to be almost half-dead to say they were having chest pain.

Of course, regions of the country have different stress levels and there is a known pain threshold difference between men and women. That being said, patients complaining of symptoms in the realm of fibromyalgia and chronic fatigue are suffering terribly, and their lives and the lives of their care-takers are in chaos.

I think the main problem for researchers in calculating the prevalence of these conditions is that researchers need to have patients fit a certain criteria of symptoms to be diagnosed with fibromyalgia and/or chronic fatigue. The Center for Disease Control (CDC) has created a criteria for diagnosis for Chronic Fatigue Syndrome.

TO DIAGNOSE A PATIENT WITH CHRONIC FATIGUE SYNDROME THE CDC CRITERIA IS THAT THEY EXPERIENCE FOUR OF THE FOLLOWING SYMPTOMS FOR 6 MONTHS:

1. Impaired memory or concentration

2. Post-exertional malaise

3. Unrefreshing sleep

4. Muscle pain

5. Multijoint pain without swelling or redness

6. Headaches of a new type or severity

7. Sore throat that is recurring and

8. Tender neck or armpit nodes.

In our practice at Mitchell Medical Group, we can see many patients with the above symptoms. Some symptoms are more severe than others and have to be treated to restore the patient to health.

man-on-bike

THE EXAMPLE WE FREQUENTLY GIVE IS:

The patient with chronic fatigue syndrome or fibromyalgia has fallen into the “ditch of life”–their symptoms have left them virtually incapacitated so that their normal everyday life has stopped and everything revolves around their illness. Our job at the practice is to help pull you out of the ditch by giving your immune system a shove in the right direction.

The treatments for Chronic Fatigue and Fibromyalgia vary and are individualized for each patient. In some cases, recurrent infections seem to throw the patient’s immune system out of sync, and we use intramuscular gammaglobulin to restore order so the immune system isn’t vulnerable to repeat infections and inflammation. In many patients we use intramuscular magnesium and a combination of antioxidants in an energy injection to restore the mitochondrial function. In some cases when the fatigue is severe we will also use intravenous high dose vitamin C infusions, which really can jump start the immune system.

The program we recommend also includes dietary changes and careful exercise when the patient is ready.

The most alarming statistic we are seeing in our practice is the number of patients in their 20’s and 30’s who are battling to overcome these conditions. Our biggest concern is that the stresses of life today, combined with poor diet and nutrition are leaving this population vulnerable to illness, when they should be in their prime years of being active.

In our practice at The Mitchell Medical Group we are especially careful to search for other underlying diagnoses that might explain a patient’s fatigue or pain. We carefully review prior records that you bring and order tests that may have been omitted.

TO QUOTE THE FAMOUS IMMUNOLOGIST DR. LOUIS PASTEUR:

“In the fields of observation, chance favors the prepared mind.”

In our practice we are prepared to do whatever we can to restore your health.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

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