ME/CFS is a neuro-endocrine-immune disorder, sometimes occurring with related auto-immune componants. There is no standard diagnostic test or cure. Some deaths have been reported due to organ failure or cancers. The exact cause of ME/CFS has yet to be determined, though some of the physiological processes themselves are well documented.
Right down to all energy producing cells, there is an enormous dysfunction. In people with CFS (PWCFS), there is the inability to produce adequate mitochondrial energy (S. Myhill, N.E. Booth, J. McLaren-Howard, 2009).
There are also significant neurological symptoms including, but not limited to: overload phenomena; seizures; extreme weakness; paralysis;difficulties processing information; sleep disturbances; cognitive dysfuntion; inability to multi-task; hyper-responsiveness to sound, smell, touch, taste, visual information [and movement]; loss of adaptability and loss of cognitive maps (Canadian Expert Medical Consensus Panel, 2003). I have added ‘movement’ to the list to reflect the experience of ME/CFS in the very severely ill; these patients may not even be able to tolerate a trip to the hospital via ambulance. They also may not be able to tolerate passive range of motion exercise without crashing.
Other signs and symptoms of ME/CFS may include, but are not limited to: neurally mediated hypotension, postural orthostatic tachycardia syndrome, delayed orthostatic hypotension, light-headedness, palpitations, fluid retention, extreme palor, bruising, lump in throat, nausea, heartburn, abdominal pain, irritable bowel syndrome, loss of thermostatic stability, excessive sweating/night sweats, hot flushes, feelings of feverishness, feelings of cold extremities, heat/cold intolerance, abnormal appetite, marked weight change, hair loss, myalgia, muscle cramps, chest pressure/pain, arthralgia, TMJ, paralysis, muscle weakness, motor/balance problems, visual and auditory disturbances, severe immune abnormalities, reproductive system problems, respiratory problems and problems with the urinary system (Canadian Expert Medical Consensus Panel, 2003).
There is a marked immune component to ME/CFS exhibiting as increased cytokines, low CD4 absolute cell count and a disturbance in RNAse L. Natural Killer cell function is often lowered, though counts may remain somewhat intact, showing that they are there but not working properly. People with ME/CFS may have viral co-infections, especially of the Herpes family viruses like EBV, CMV, HHV-6.
Gut dysbiosis is often problematic due to overgrowth of myriad bacteria, yeast, parasites and/or presence of enteroviruses. Levels of 'friendly' bacteria like L. acidophilous and L. bifidus may be lowered or non-existent. This further affects immune function and CNS negatively.
Hormones like estradiol, progesterone, testosterone, T3, TSH, T4, cortisol and DHEA may be low and/or out of balance. Cortisol and DHEA in low ranges suggest malfunction of adrenal glands to adapt to stress, causing adrenal exhaustion.
There is a hypothalmic-pituitary-adrenal axis disturbance.
"Chronic Fatigue Syndrome patients exhibit evidence of diastolic dysfunction [a type of heart failure] at a level well above that reported for control populations of the same age. Energy dependent diastolic dysfunction would appear to be a hallmark of CFS and supports the hypothesis that CFS is a syndrome of cellular energy deficiency” (P. Cheney, 2007). There is cardiomyopathy in ME/CFS patients, as evidenced in heart biopsies (A.M. Lerner et al.).
In many patients, low circulating blood volume, low RBC mass and low plasma volume have been cited (D. Bell, D.H.P. Streeten).
In October 2009, the prestigious Science journal reported a study finding the novel retrovirus XMRV implicated in 67% of samples tested from people with ME/CFS, whereas the general population had an occurrence of about 3.75% (J. Mikovits, V. Lombardi et al., 2009). Murine leukemia viruses (MLV) related gene sequences have been detected in blood sample collected from about 87% of patients diagnosed with chronic fatigue syndrome (CFS) and 7% of healthy blood donors, according to a study published by the scientific journal Proceedings of the National Academy of Sciences (PNAS) (Lo et al., 2010) The findings in this study are linked to the earlier XMRV findings, as XMRV is a genetic variant of MLV. MLVs (including XMRV) are novel human retroviruses. What this means to the ME/CFS patient is unclear at this point: are these retroviruses cofactors in ME/CFS, or are they the cause of ME/CFS? Research continues ... the blog has lots more on XMRV and new developments of all kinds to keep you up-to-date.