Severe Fatigue is not the same as ME/CFS
US researchers led by Prof Komaroff found that severe fatigue was much more common than ME/CFS in a large group of nurses and the triggers were different. There was an increased risk of ME/CFS in people with a history of mononucleosis (or glandular fever).
Research abstract:
Fatigue is a common reason that patients seek medical care. Only a fraction of these patients meet criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
To determine if ME/CFS is just a more extreme form of fatigue, or a qualitatively different condition, we assessed whether risk factors for ME/CFS and for Severe Fatigue were similar. An email questionnaire that inquired about symptoms of Severe Fatigue and ME/CFS was completed by 41,802 US female nurses from whom detailed medical and lifestyle information had been collected since 1989.
- 102 met criteria for ME/CFS
- 522 had Severe Fatigue
- 41,178 individuals were without significant chronic fatigue.
We used Cox proportional hazards regression to estimate the Hazard Ratio (HR) of Severe Fatigue and of ME/CFS with each of several potential risk factors, according to the level of exposure to each risk factor.
The risk of Severe Fatigue was significantly increased among
- participants who were older,
- had a higher BMI in adulthood,
- used hormone therapy,
- had increased alcohol intake
- and decreased caffeine intake.
In contrast, these risk factor associations were not seen in people with ME/CFS. A self-reported past history of acute infectious mononucleosis was associated with a non-significantly increased Hazard Ratio of later ME/CFS (HR 1.77, 0.87–3.61) and, to a lesser extent, of Severe Fatigue (HR 1.28, 0.98–1.66).
The different contribution of various risk factors to Severe Fatigue and ME/CFS suggests that ME/CFS has a qualitatively different underlying biology from the more common state of Severe Fatigue.
Different risk factors distinguish myalgic encephalomyelitis/ chronic fatigue syndrome from severe fatigue, by Natalia Palacios, Samantha Molsberry, Kathryn C Fitzgerald & Anthony L Komaroff in Scientific Reports vol 13, no.: 2469 (2023)
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