Interview with Dr. Manuel Blanco, internist at the SHC Medical Unit of Viamed Santa Ángela de la Cruz Hospital in Seville.

• What is Chronic Fatigue Syndrome?  

Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis is a systemic disease characterised by intense physical and mental fatigue that does not subside significantly with rest and worsens with exertion. This chronic and debilitating disease directly and negatively affects the quality of life of the person who suffers it. Its cause is unknown although multiple factors have been implicated in its aetiology: genetic, environmental and infectious diseases, stress, immunoneuroendocrine dysfunctions, among others. This means that is is part of Central Sensitivity Syndrome (CSS) along with fibromyalgia, multiple chemical sensitivity and electromagnetic sensitivity. Generally, over time, people with CFS develop the other pathologies of CSS.
The clinical manifestations of CFS are very wide-ranging, including cognitive fatigue, post-exertional discomfort and sleep disturbance, digestive disorders, and intense and generalised pain.

• Is it related to fibromyalgia?

They are not the same. Fibromyalgia is characterised by the presence of chronic pain in different areas of the body, without the existence of inflammation or degenerative processes. It can be said that poor processing of pain stimuli is capable of causing central sensitisation and lowering the pain threshold, generating generalised hypersensitivity. This produces the appearance of various symptoms such as sleep disorders, lack of energy, cognitive and central nervous system disorders, digestive symptoms, among others, which affect the quality of life of those who suffer it. Although they are not the same, the physiopathological reasons behind them are similar and, as is mentioned before, it is an immunoneuroendocrine dysfunction.

• What treatments are available for it?

There are different lines of action for this type of patient. In our Unit we have had significant success in improving the quality of life of CFS patients with multifunctional treatments, such as therapeutic diets for food desensitisation, as well as oxygen therapy treatments for hypoxia and hyperoxia. We presented this technique at the II Symposium of CSS that was held last October in Seville, where we showed that more than 70% of the patients that follow this treatment improve their quality of life by more than 70%. We are also developing serum therapy protocols that are producing positive and encouraging results.

• How does lifestyle and diet influence this disease?

They have a direct influence as CFS patients suffer an immunoneuroendocrine dysfunction that is affected by lifestyles and diet. It is important to clarify that there is no such thing as a standard lifestyle or diet for these patients, as the immune sensitivities in each individual are so different that to attempt to follow a single protocol would be to leave many loose ends for each patient. However, what certainly helps all patients is to have a healthy lifestyle and diet, sustainable over time and structured according to their needs.

• Is genetics important?  

Genetics can have an influence, although there are no studies showing that CFS is caused by genetic alterations or mutations. Studies do exist correlating these types of alterations with CFS symptoms. As mentioned above, we still do not know the cause of CFS, but every day we discover more about the multiple physiopathological reasons that can generate it and this gives us important information and opens paths to take action and offer better care to these patients.