Fibromyalgia? Chronic Fatigue Syndrome?

There is a lot still unknown about fibromyalgia (FM) and chronic fatigue syndrome (CFS) also called CFIDS (chronic immune deficiency syndrome) but I think it is becoming more apparent there are certain factors that effect the symptoms. Why are some on disability & bed ridden while others "seem to be fine" and work full-time. Part is how adversely the body is effected, part is lifestyle and stress factors and part is still unknown. My personal theory is that there is apparently abnormalities that causes the body to be suseptical to FM & CFS. Certain triggers (extreme emotional stress, major injury, illness, environmental factors, etc) triggers an autoimmune response that attacks the nervous system triggering symptoms of CFS/FM. This gradually worsens as the triggers continue or multiply. Once the precipitating triggers cease or decrease then the person's symptoms may decrease or stablize. When the individual experiences routine stress fluxuations, hormonal changes, baromic changes in the weather, extremes in temperature, certain foods in the diet, etc, these factors can cause what is commonly called flare ups. The degree of symptoms seem to depends on the individual body's makeup, perception, tolerances, personality, etc., as well as severity of the precipitating factors and ongoing lifestyle and beliefs.

I will include links & information which I find that support this theory. Any researchers are welcome to take this theory to do farther investigations.

A New Day
Every sunrise is the beginning of a new day.
You have been given this day to use as you will.
Think it over How society has changed to promote disease, isolation & depression. What we need to do to decrease stress & enjoy life more.

Type A Personality Test "Type A characteristics have been linked to an increased risk for coronary heart disease and cancer. Your score will tell you whether you have the characteristic traits of a Type A, Type B, or Type C person, and how these inclinations may be affecting your life. Free simplified results will give you your Type A score and a brief interpretation of what it means."

Clinical Practice Guidelines for Chronic fatigue syndrome Clinical practice guidelines — 2002, Produced by a Working Group convened under the auspices of the Royal Australasian College of Physicians This supplement to the MJA was funded by a grant from the Commonwealth Department of Health and Ageing.
Diagnostic criteria for chronic fatigue syndrome

1. Fatigue
Clinically evaluated, unexplained, persistent or relapsing fatigue persistent for six months or more, that:

is of new or definite onset;
is not the result of ongoing exertion;
is not substantially alleviated by rest;
results in substantial reduction in previous levels of occupational, educational, social or personal activities;

2. Other symptoms
Four or more of the following symptoms that are concurrent, persistent for six months or more and which did not predate the fatigue:

Impaired short term memory or concentration
Sore throat
Tender cervical or axillary lymph nodes
Muscle pain
Multi-joint pain without arthritis
Headaches of a new type, pattern, or severity
Unrefreshing sleep
Post-exertional malaise lasting more than 24 hours

Clinical history
It is important to take careful note of the character of the fatigue. In people with CFS, fatigue is typically exacerbated by relatively minor physical or mental activity, and is associated with a protracted recovery period lasting hours or days. The fatigue should be differentiated specifically from weakness (neuromuscular disease), dyspnoea and effort intolerance (cardiac or respiratory disease), somnolence (primary sleep disorders), and loss of motivation and pleasure (major depression).

Additional clues which could point to alternative diagnoses include unexplained weight loss (occult infection, malignancy, thyrotoxicosis, Crohn's disease); dry skin and cold intolerance (hypothyroidism); snoring and daytime sleepiness (sleep apnoea); risk factors for transmission of blood-borne infections (HIV, hepatitis C); prior episodes of depression or anxiety (vulnerability to psychiatric disorder); arthralgia or rash (connective tissue disease); and prescribed or illicit drug misuse. A history of altered bowel habit may indicate an underlying gastrointestinal infection (eg, giardiasis), coeliac disease, thyroid disease, or inflammatory bowel disease.

Characteristically, there are no abnormal physical findings in people with CFS. The physical examination and mental state examination are therefore primarily directed towards excluding other disorders. A careful assessment for neurological deficits or signs of anaemia, cardiac failure, respiratory disease, hidden infection, connective tissue disease or tumour should be conducted. The presence of persistent fever, lymphadenopathy, or enlargement of the liver or spleen are not features of CFS and always warrant further investigation.

The behavioural signs of psychiatric disorder should also be sought, including psychomotor slowing (major depression), physiological arousal (anxiety states and panic disorder) and cognitive deficits (delirium or dementia).

There are currently no validated laboratory tests to confirm the diagnosis of CFS, assess its severity or monitor progress. Hence, the purpose of laboratory investigation is to help exclude other disorders.

Recommended screening investigations are:

full blood count and erythrocyte sedimentation rate;
serum electrolyte, calcium and creatinine levels;
biochemical liver function tests;
thyroid function tests (TSH); and
urinalysis for blood, protein and glucose.

Additional investigations should be ordered only if the history or examination plausibly suggests other diagnoses (eg, autoimmune connective tissue disease, coeliac disease), or if abnormalities are found in the screening investigations. Routine analysis of immune function (lymphocyte subsets, immunoglobulin levels), infectious disease serology, or environmental toxins are not recommended.
Unvalidated diagnostic tests should only be performed in the context of an appropriately designed and ethically approved clinical trial.

New insight on eyesight "Your vision can be affected by nutrition, your environment and even stress, according to "behavioral optometrists." Another artical contributing these factors to our health.

The enemy within: Women and autoimmune diseases Good overview of autoimmune disease from Mayo Clinic which contributes environmental toxins as well as hormonal influences on autoimmune disease.

Cheney on "chronic neurotoxin" protocol: Questran/cholestryamine Dr. Paul Cheney who is a prominent name in CFS research is now adapting Dr. Ritchie Shoemaker's theory that neurotoxins is a factor behind the development of CFS & FM.

This theory is beginning to draw more attention and research.

CFIDS pathway similar to Pfeisteria neurotoxic damage?

I would like to share a portion of a personal email I received from Dr. JoAnn Burkholder, NC State University professor and discoverer of the neurotoxic aquatic organism pfiesteria. Dr. Burkholder has also been researching the health effects on humans in the fish kill area, who are suffering symptoms similar to CFIDS. Sensitivity to bright lights, memory problems, neurocognitive symptoms, etc. After exposure, it has been noted as well, that those affected are extremely sensitive to chemicals.

These are the important parts of her email:

Our colleagues at the National Ocean Service in Charleston have finally succeeded in purifying a potent water-soluble Pfiesteria neurotoxin, and our research team has initiated the patenting process. Colleagues at Duke University/Duke Medical have injected rats with the purified toxin and the learning centers in their brain are destroyed. The lead PI in that work, Dr. Ed Levin, has published numerous peer-reviewed articles, most recently in Environmental Health Sciences (10/2000). Our NOS-Charleston colleagues have DETERMINED A MODE OF ACTION FOR THE TOXIN - IMPORTANT * " It acts as an ATP neurotransmitter that targets P2X7 receptors, which act as a first line of communication between THE NERVOUS, IMMUNE AND ENDOCRINE SYSTEMS "

What is the proposed name change for CFIDS by the Working Group? Neuroimmunendocrine Dysfunction Syndrome.

Hope this information is a clue in the puzzle.

Margaret Holt
Greensboro CFIDS/ME Support Group

[Moderator's Note: This may be of interest, given the current direction of characterizing CFS as a neuro-endocrine dysfunction.]
Endocrine Disrupting Chemicals: New Publication Shows Need For Further Research

August 13, 2002

(WHO) -- Are human sperm counts declining due to exposure to certain environmental contaminants? Is human breast cancer increasing due to exposure to organochlorine chemicals? Are chemicals that have the potential to interfere with the normal functioning of the endocrine system (often referred to as endocrine disrupting chemicals or EDCs) threatening future generations of humans and certain wildlife species?

A new publication concludes that the evidence that human health has been adversely affected by exposure to EDCs is generally weak, but that further research and information is needed. The publication is available on the web at

The report concludes that there is sufficient evidence that adverse effects have occurred as a result of exposure to EDCs in some wildlife species. Therefore, because of continuing concerns and scientific uncertainties, studies on the potential effects posed by these chemicals should remain a high global priority requiring coordinated and strengthened international research strategies. There is, in particular, an urgent need for studies in vulnerable populations, and especially in infants and children, since exposure during critical developmental periods may have irreversible effects, concludes the report.

The report, entitled "Global Assessment of the State-of-the-Science of Endocrine Disruptors", is the result of a global comprehensive review of the publicly available scientific literature on EDCs organized by the International Programme on Chemical Safety (IPCS). The IPCS is sponsored by the World Health Organization (WHO), the United Nations Environment Programme (UNEP) and the International Labour Organization.

This assessment was requested in 1997 by the Intergovernmental Forum on Chemical Safety, the 1997 Declaration of the Environment Leaders of the Eight on Children's Environmental Health, and endorsed by the 50th World Health Assembly in 1997.

Over 60 international scientific experts provided input into this document either as IPCS Steering Group Members, chapter leaders, authors, or reviewers. The assessment is unique in providing a global perspective on the endocrine disruptor issue, and in providing a framework by which strength-of-the-evidence analysis can be performed to determine whether there is a causal association between an adverse biological effect and exposure to an endocrine disrupting chemical.

Financial support for this project was provided by the US Environmental Protection Agency, the US National Institute of Environmental Health Sciences, the European Commission, the Government of Australia, Health Canada, the Institute of Public Health, Norway, the Japanese Ministry of Health, Labour and Welfare, the German Ministry of Environment, the Swedish Environmental Protection Agency, the Swedish Chemicals Inspectorate, the Swedish Foundation for Strategic Environmental Research, the UK Department for Environment, Food and Rural Affairs, and the UK Department of Health.


Co-Cure Web Site:

Environmental Factors Effect Our Health More articals & links to sites addressing environmental chemicals and toxins effect our health.

Safe 2 Use Information on various pesticides & toxins.
About Volatile, Synthetic Pesticide Poisons More specific information including link to list of Symptoms of Pesticide Poisoning.

Steve Tvedten site on Toxins More links & articals on various types of toxins.

Link Seen Between Cooking, Cancer "Busk said that the chemical, acrylamide, which is used industrially in the manufacture of some plastics, is also apparently formed by the heating of starches. He said that there is no reason to think that acrylamide levels are higher in Swedish foods than in similar European or American products. Foods with especially high levels of the chemical included french fries, potato chips and crackers.
A Food and Drug Administration official said yesterday that the agency had not reviewed the report but that it considered the source to be "credible."
"We will move as expeditiously as possible to evaluate all data relevant to this issue to protect the public health," the official said.
The Swedish report said that high doses of acrylamide have been shown to cause cancers and that "it seems reasonable to conclude that a significant number, perhaps several hundred, of the annual cancer cases in Sweden can be attributed to acrylamide."

This is an example of how unhealthy foods are adversely effecting out health. These pollutants and adverse chemical changes may likely be a factor to the increasing common health problems we are facing today.

Amalgam Illness Diagnosis and Treatment The site focuses on selling Andrew Hall Cutler's (PhD, PE) book on mercury poisoning but it's an example of how people are feeling how environmental factors is causing many of these unusual medical conditions many people are experiencing today.

Military linked to Cape water taint Artical gives an example of toxins created by man getting into the environment & effecting a community's water supply.

The vestibular system, a tool to study neurotoxicants in the central nervous system "The vestibular and opto-ocular motor system was also used in an otoneurological test battery to investigate the effects on the CNS in workers, long-term exposed to solvents. Dynamic posturography was also performed to obtain an indication of the integration of somatosensory, visual, and vestibular stimuli in the equilibrium system. Reduced ability to visual suppression, prolonged latency of saccades and pathology in the posturography tests were found in the solvent exposed group compared to results of a non-exposed healthy control group.

All exposed worker bad been evaluated for a possible chronic toxic encephalopathy (CTE) and were categorized in three groups non-CTE, incipient CTE, and CTE. These categories, based on psychometric test results and case histories of exposure and symptoms, were poorly correlated to the otoneurological findings. Even in the non-CTE group pathological findings were present. Lesions in the CNS revealed by an otoneurological investigation were apparently not found in the neuropsychological investigation. This indicates that an otoneurological test battery could contribute valuable information in the evaluation of long-term solvent exposed people suspected for CTE.

The studies related above, demonstrate that the vestibular and opto-ocular motor system is an useful tool in evaluating toxicological effects in the CNS."

Chem-Tox.Com Information compiled by Wayne Sinclair, MD, Allergy, Asthma & Immunology
Richard Pressinger, M.Ed., Tampa, FL
"The following index provides links to research finding health disorders resulting from exposure to common chemicals and pesticides. Illnesses now identified include child cancers, neurological disorders, immune system weakening, asthma, allergies, infertility, miscarriage, and child behavior disorders including learning disabilities, mental retardation, hyperactivity and ADD (attention deficit disorders)"

These are some sites someone had emailed me on environmental factors that can adversely effect our health.

Council on Wireless Technology Impacts "The Council on Wireless Technology Impacts was formed in 1997 in response to an unmet need, to provide information, education and advocacy on the public health needs and concerns related to non-ionizing EMR (electromagnetic radiation.) We encourage the development and application of safer technologies which use man-made radiation, to protect the health of our children at home and at school, our daily work environment and our communities."

The Swedish Association for the ElectroSensitive Site has lots of articals on health problems caused by "modern technology".

International Conference on Cell Tower Siting Linking Science & Public Health, Salzburg, June 7-8, 2000 More articals on adverse effects of the environment on health.

Research Center for Bioelectromagnetic Interaction Another site on the effects of electro-magnetic fields.

EMF Research Database You can search topics of research & it'll bring up the list of related research studies. Don't be too specific. ex.Frequency Sub-Range: MRI & Country: United States. This may not bring up any articals but being more general will bring them up.

Wave-Guide.Org Another site on the adverse effects of technology on our bodies.

MICROWAVE NEWS More information on EMFs and health.

PowerWatch "Electromagnetic fields come from powerlines, substations, electric appliances in the home, mobile phones and their base station antennas and masts. We are now surrounded by man-made EMFs millions of times higher than the natural background ones. We believe that research does show that exposure to EMFs can cause adverse health effects in people and animals."

Cellular News This site is also useful in checking out cellular phone coverage areas in all the world. This could be useful if you are considering getting a cell phone.

Abstract: Is Fibromyalgia a Neurologic Disease?

Journal: Curr Pain Headache Rep 2002 Apr;6(2):106-14

Authors: Bradley LA, McKendree-Smith NL, Alarcon GS, Cianfrini LR.
Affiliation: University of Alabama at Birmingham, Division of Clinical Immunology and Rheumatology, 475 Boshell Diabetes Building, 1808 7th Avenue South, Birmingham, AL 35294, USA.
NLM Citation: PMID: 11872181

Fibromyalgia (FM) is characterized by abnormal pain sensitivity in response to diverse stimuli as well as persistent widespread pain and other symptoms such as fatigue and sleep disturbance. Progress has been made in identifying factors that contribute to the etiopathogenesis of abnormal pain sensitivity, but there is no single model of pathophysiology or treatment of FM that has gained wide acceptance among health care professionals.

We review the literature on the etiopathogenesis of abnormal pain sensitivity in FM and describe an explanatory model that serves as a source of testable hypotheses in our laboratory. This model posits that interactions of exogenous (e.g., environmental stressors) and endogenous (e.g., neuroendocrine dysfunction) abnormalities in genetically predisposed individuals lead to a final common pathway, i.e., alterations in central nervous system function and neuropeptide production that underlie central sensitization and abnormal pain sensitivity.

This model also suggests that efforts to develop and evaluate treatments for FM should focus on interventions with direct or indirect effects on central functions that influence pain sensitivity.

The Relations Among Body Consciousness, Somatic Symptom Report, and Information Processing Speed in Chronic Fatigue Syndrome "Levels of private body consciousness directly affected somatic symptom report and information-processing speed. This finding supports the role of attentive processes in CFS, and offers, besides possible cerebral dysfunction, an alternative explanation for slowing of information processing in CFS."

Autoimmune Illnesses "Autoimmune Diseases are complex, multiorgan diseases of unknown etiology. Although we do not know exactly what causes Autoimmune Diseases, there is increasing evidence that in many patients chronic infections, particularly by certain bacteria and viruses, play an important role in these diseases along with genetic predisposition and immune dysfunction. How could infections be important in Autoimmune Diseases? They could be involved in helping to cause the illness, or they can affect patients by serving as cofactors for the illness (not causing illness on their own but serving as important factors in the disease process) or even as opportunistic infections that increase patient morbidity (sickness) and complications associated with the disease.

Our recently published studies demonstrated a possible link between mycoplasmal infections and Rheumatoid Arthritis, since we found high frequency of multiple mycoplasmal infections in these patients (Haier et al., 1999). Previously we examined a variety of patients with chronic illnesses for the presence of mycoplasmal infections. We found that about one half other autoimmune diseases (Inflammatory Bowel Diseases, Sjögren's, Hashimoto's, Graves', Reiter's, Crohn's Diseases and others) are also associated with mycoplasmal, chlamydial, and other infections."

What you should know about pain USA Today Artical explains the problems associated with chronic pain. "Of the 75 million Americans who have chronic pain, only 1 in 4 receive proper treatment, according to the American Pain Foundation. In fact, pain is one of modern medicine's most misunderstood, underdiagnosed and untreated health problems. Pain experts consider it a national epidemic, and Congress officially declared 2001-2010 the Decade of Pain Control and Research."

Pain is defined, by scientific groups that study it, as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage."

And that sweeping description is part of the problem, says Michael Clark, a psychiatrist and director of the Chronic Pain Treatment Program at Johns Hopkins University School of Medicine. "There is no one-size-fits-all definition for pain. It's a very personal experience."

Sharp. Jabbing. Burning. Nagging. People can use the same words to describe different sensations. And one man's twinge is another man's -- or woman's -- agony because pain thresholds vary. (Interestingly, experiments show that men generally have a higher threshold of pain than women.)

Yes, we all know when we're feeling pain; often we can direct doctors to what we think is the source. And doctors are adept at looking for damage and symptoms, testing a hypothesis and reaching for the right medicine. But when a pain's cause is elusive, doctors in the past too often "figured if we don't know what's wrong with you, you're crazy. If there's no test for it, it doesn't exist," says Jacob Teitelbaum, director of an Annapolis (Md.) research center devoted to chronic pain and fatigue and author of a widely read paperback, "From Fatigued to Fantastic" (Penguin/ Avery, $13.95).

Damage to muscles and other tissues cause pain, as do neurological factors or distress to a nerve. Disease causes pain. Sometimes our behavior -- running or drug use -- brings it on. It also can be traced back to psychological problems, which present themselves as pain. Personality factors, such as low pain tolerance, also play a role.

For optimum results, all of these factors -- tissues, neurology, disease, behavior, psychology and personality -- need to be addressed together. When they are, the diagnosis might be such recently identified pathologies as chronic fatigue syndrome, fibromyalgia syndrome, myalgic encephalomyelitis or myofascial pain syndrome -- four incompletely understood conditions that have pain as a common denominator."

The field of biotechnology is now looking at the physiology of pain -- the systems that detect something wrong and send a pain message to the brain -- and the neurotransmitters and receptors involved in that process.

Researchers have discovered that one, the mu opioid receptor, comes in hundreds of varieties. Each variety responds to different pain relievers -- from morphine to aspirin. One day, doctors may be able to do a simple test to determine which painkiller will work best for an individual sufferer, a process that until now has been mostly trial and error.

Neuroenndocrinology, Genetics and Chronic Fatigue Syndrome "Neuroendocrinology focuses on the integrated nervous system and hormone release network that links the brain, pituitary and many endocrine glands. A subset of that network is the stress system, which is composed of the pituitary adrenal axis and sympathetic nervous system and coordinates release of cortisol, norepinephrine and epinephrine in response to acute stressors. These systems may play a role in chronic fatigue syndrome (CFS) and other conditions involving fatigue."

Center for Complex Infectious Diseases "The primary mission of CCID is to determine the nature, origin, disease associations, modes of transmission, methods of diagnosis and responses to therapy of complex infectious diseases, and to disseminate such information. CCID is currently specializing in the detection and characterization of viruses which have undergone a "stealth" adaptation to avoid elimination by the immune system. It bas now been scientifically proven that stealth viruses do, indeed, exist and can be at the root of many multi-system neuro-degenrative illnesses, such as Chronic Fatigue Syndrome, fibromyalgia, attention deficit disorder, autism and other diseases causing behavorial changes."

Dr. Teitelbaum recommends the following tests.

"What tests do I need to do to be evaluated for my CFS/FMS?

Although there is no test that is needed to diagnose CFS/FMS, there are many tests that can be helpful in determining what treatments you need. Beyond this, there are tens of thousands of dollars worth of tests that can be done that will be abnormal and quite interesting yet totally useless in helping you to get well. As my focus is on effective treatment, I'll only be discussing the more common tests that will affect my initial treatment recommendations. My book discusses many other tests that, although helpful, are only used in selected patients. It also discusses which diagnoses and symptoms to use for each test so that your insurance is most likely to cover it. If your physician will not order the tests for you, you can get a lab requisition form for these tests on my web site at a

Tests that I recommend as part of the initial evaluation in all CFS/FMS patients:

1-Complete blood count (CBC). This common and inexpensive test gives us a wealth of information. If the WBC (White blood cell count) is high (over 9000) it leaves me more suspicious of an antibiotic sensitive infection. If it is low with a high lymphocyte count, especially if atypical lymphocytes are present, this is more suggestive of a viral infection. An elevated eosinophil count suggests allergies or parasite infections. The tests also look for anemia and evidence of iron, folate, or B12 deficiencies. It also screens for blood cell cancers and can give evidence of many other problems.

2 -- Sedimentation rate (ESR)-this test is only considered significant medically if it is elevated (i.e. -- over 20). It screens for inflammation. In most people with CFS/ FMS it actually is lower than normal. If it is modestly elevated I look for inflammatory processes more aggressively and will routinely use low-dose Cortef treatment. If it is over 50 in a patient who is over 50 years old, that patient needs to be evaluated for polymyalgia rheumatica, a very treatable inflammatory condition which mimics FMS but is a very different process.

3 -- A general chemistry -- although there are many panels it should include at least a blood sugar (glucose), BUN and creatinine (checks for kidney function and dehydration), SGOT and SGPT (also called alt and ast), bilirubin and alkaline phosphatase (to check for liver and bone diseases), albumin (protein), calcium, magnesium, sodium, potassium, and uric acid levels.

4 -- Iron, TIBC (total iron binding capacity), percent saturation and ferritin levels. These tests check for iron deficiency and excess. Both of these are critical to detect. If the iron is high, it is very easy to treat (donate blood) but can cripple and kill you if it is missed. Iron deficiency will often be present even if the blood tests are technically normal. This is because the blood test's normal range is based on preventing anemia from severe iron deficiency. More moderate levels of iron deficiency, however, can cause fatigue, brain fog, cold intolerance, restless leg syndrome, immune dysfunction, and infertility. Because of this, I usually recommend treating with iron if the percent saturation is less than 22 percent OR the ferritin level is less than 40. I recheck each four months until the blood tests come above these levels.

5 -- Vitamin B12 level. Although normal is anything under 209, evidence suggests that significant B12 deficiency occurs at much higher levels even in healthy people. Other evidence suggests that very high levels may be needed to maintain optimum health in CFS/FMS patients. I recommend that anybody with a level under 540 be treated with B12 shots. A good argument can be made for treating everybody with CFS/FMS with B12 shots regardless of the blood level.

6 -- Thyroid testing. Many doctors will only check a TSH blood test to evaluate thyroid function. Unfortunately, this test is very unreliable in the presence of hypothalamic dysfunction. If the TSH is over three, it strongly suggests that you should be treated with thyroid hormone. I would also check a free T4 level. This checks the level of the active hormone. The interpretation of other T4 hormone tests is difficult because protein binding is altered in CFS. In the experience of many physicians, and this has been supported now by several studies, thyroid blood tests will miss the large majority of people who need thyroid hormone therapy. If you have symptoms of low thyroid (to be discussed in a future newsletter) you should be treated with thyroid hormone regardless of the blood test results.

7 -- A cortisol and DHEA-sulfate (DHEA -S) level. These should be drawn before 9 AM and before eating or drinking anything besides water that morning. If the cortisol is under 14 mcg/dl or if the patient has symptoms of a low adrenal, I would treat with very low-dose Cortef (usually 5-15 milligrams daily which is about equal to 1- 3 mg prednisone). If the DHEA- S is less than 120 mcg/DL in a female or 350 mcg/DL in a male I will usually treat with DHEA. Do not use the DHEA in the presence of hormone sensitive cancers (e.g. breast, ovarian and prostate) unless approved by your physician.

8 -- A urinalysis -- this screens for infections, bleeding, diabetes, and dehydration.

These tests are the most important tests to be done in any patient with CFS/FMS. Many other tests can also be helpful but are less critical."

Scripps Team Finds Supporting Evidence For An Autoimmune Factor In Chronic Fatigue Syndrome "The study found that approximately 52 percent of patients with chronic fatigue syndrome develop autoantibodies to components of the nuclear envelope protein. According to Dr. K. Konstantinov, from the Scripps Research Institute, LaJolla, California, previous studies led to the hypothesis that chronic, low- level activation of the immune system is an etiologic factor in chronic fatigue syndrome. Dr. Konstantinov and others investigated the blood of 60 affected patients for evidence of this activation. The researchers observed that the nuclear envelope-specific autoantibodies of the IgG isotope reacted predominantly with the nuclear envelope protein Iamin B1, providing new laboratory evidence for an autoimmune component in chronic fatigue syndrome.

The Scripps team concluded that the humoral autoimmunity against polypeptide of the nuclear envelope, in addition to other disturbances of the immune system, is a prominent immune derangement in chronic fatigue syndrome."

R.E.D.D., Rnase-L Enzyme Dysfunction Disease & CFS Lots of links on both conditions.

Protein May Lead to First Test for CFIDS "In the new study, Kenny De Meirleir, MD, PhD, and colleagues from the Vrije University of Brussels, Belgium, looked for the presence of a protein known as 2-5A binding protein in the blood of 57 people who had had CFS for an average of seven years. They compared blood samples from these patients with blood from healthy subjects and patients with fibromyalgia or depression.

The protein was found in 88% of CFS patients, 38% of fibromyalgia patients, 32% of healthy people, and 14% of depressed patients.

According to the researchers, the protein is directly involved in the immune system's ability to fight viruses that can invade the body. Up to 90% of patients with CFS report that their symptoms started after a viral infection. This has led some researchers to suggest that certain viruses may actually cause CFS. But others say a dysfunction of the immune system that causes it to fail to respond, or to over-respond, to invading viruses may lead to CFS symptoms."

Breakthrough in battle against CFS

A brand-new test can mean an important breakthrough for treatment of CFS and MS.

The biotechnological concern RED, in cooperation with an international research-team, has succeeded in developing a test, that make it possible to diagnose this chronic immune illness in a scientific manner.

The blood test (a Yes/NO test), don't cost more than 25 euro. "This test is an important step forward" said professor Kenny De Meirleir. "How later the diagnosis, how more irreversible damage is brought about. We now know, that CFS do harm to the thyroid glands, already after three till for years.

Worldwide millions of people are stricken by chronic immune diseases and this number is rising. The first medicines will come on the market, at the earliest in three till five years.

Who is Calpain and why is he so mean to my RNaseL?

A Simplified interpretation of "G-Actin Cleavage Parallels 2-5A-Dependent RNase-L Cleavage in Peripheral Blood Mononuclear Cells - Relevance to a Possible Serum-Based Screening Test for Dysregulations in the 2-5A Pathway"

Enzymes are proteins which work to accelerate chemical reactions of various kinds. RNase-L is an enzyme. ATP provides the energy to cause the creation of this enzyme as a specific response to RNA of viral origin. Normally, RNase-L helps breakdown the RNA (genetic information) of viruses and old cell bits.

The usual weight of RNase-L is 80kDa. (A kilodalton - kDa - is a very tiny measure of weight on the atomic level.) Researches find that CFS sufferers have RNase-L molecules which are about half of normal -- 37kDa. These low-weight enzyme molecules are unable properly to carry out their purpose of destroying viruses. These RNaseL molecules may have been cleaved (or split) in half by calpain. This is not normal.

Calpain is also an enzyme, a proteinase). Proteinases are meant to break down proteins. This one prefers Actins, proteins used in muscle activity. This is normal to clean up used proteins. However, any abnormal breakdown of actin protein could have dramatic consequences on the ability of an immune cell to perform its normal function. When calpain does a bad job of chopping up old actin, the fragments are not cleared away as rapidly. By comparing the leftover actin fragments and RNase-L fragments in the blood, there seems to be a direct relation between the two. This may be a way to test for CFS. The greater the percentage of "skinny' RNase-L, the worse the CFS symptoms may be, according to Dr. Suhadolnik. Data also support greater than usual immune cell destruction in every stage of CFS.

A blood-based marker used as a screening test for CFS would make diagnosis much easier and cheaper. A test was developed by R.E.D. Laboratories called The Fragmented Actin Serum Test (FASTest™). This test is used for clinical purposes and can be ordered by a physician. Conditions that have been proposed to trigger the development of CFS include virus infection or other temporary traumatic conditions, stress, and toxins environmental (pesticides) or natural (pfiesteria).

This artical came from Co-Cure but the link was to a German site written in German.
Co-Cure Web Site

[YOUR HEALTH Ask Dr Gupta]

Treatment for fibromyalgia

Editor's Note: Every Saturday on "Your Health" at 2:30 p.m. EST, Dr. Sanjay Gupta answers your medical questions submitted by e-mail. The questions and answers are posted on after the show.

Q: How do you treat fibromyalgia and does yoga or other forms of exercise work? -- Janice in Hudson, Florida

A: Fibromyalgia, a condition characterized by aching and pain in muscles, tendons, joints and the spine, often seems worse during relaxation and is less noticeable during busy activities and exercise. So aerobic exercise does play a key role in the treatment of fibromyalgia. Other approaches include pain relief medications and relaxation techniques, including massage.
In yoga, your joints, muscles and nerves are stretched and strengthened and deep breathing releases tension, so it is a good way of alleviating the pain of fibromyalgia. But remember that a comprehensive approach planned with your doctor is your best treatment plan.
(c) 2002 Cable News Network/AOL-Time Warner Company

GLYCONUTRITIONAL IMPLICATIONS IN FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME "Regardless of the precise mechanism(s) of pathogenesis for FM/CFS, it should be clear from this review of the most recent scientific and medical literature that the immune (eg. cytokines, lymphocytes, virus infection), endocrine (eg. hormones), nervous (eg. neurotransmitters, sleep pathways, psychological stress) and muscular (eg. tender points, cardiovascular deconditioning) systems of the body are all intimately involved in the FM/CFS syndrome. It should also be apparent that the necessary glycoconjugate sugars and complex carbohydrates all play important roles in maintaining the health and normal functioning of these systems. Moreover, dietary mannose (and, perhaps, other necessary glycoconjugate sugars) has been shown to be well absorbed and preferentially utilized for biosynthesis of glycoproteins in humans. Maintenance of body health also seems particularly important, considering the major medical and pharmaceutical challenges of diagnosis and therapy of FM/CFS and the long-term difficulties facing FM/CFS patients. Certainly, the complex pathogenesis of FM/CFS and variations in symptoms among individual patients combine to challenge the medical understanding of these debilitating syndromes."

Glyconutritionals and Health: Saccharide-Specific Reviews "This section contains one review paper devoted to each of the known necessary dietary sugars. Each paper reviews current scientific knowledge about the biological activities of a particular sugar and provides information about how the sugar is absorbed, distributed, and metabolized in the body after consumption in the diet. Recent scientific research demonstrates that the necessary sugars can be readily absorbed and directly incorporated into glycoproteins and glycolipids when consumed in the diet. Important biological activity has also been documented for these sugars." These sugars are: Fucose, Galactose, Glucose, Mannose, N-AcetylGalactosamine, N-AcetylGlucosamine, N-AcetylNeuraminic Acid, and Xylose.

It's Not All In Your Head Pain & other symptoms of FM, what is the debate about?

CHRONIC FATIGUE SYNDROME AMONG PHYSICIANS: A POTENTIAL RESULT OF OCCUPATIONAL EXPOSURE TO STEALTH VIRUSES "Four physicians with complex chronic disabling illnesses labeled as chronic fatigue syndrome (CFS) were shown by culture to be stealth virus infected. The clinical histories indicate multi-system stealth virus infection with encephalopathy... Complex arrays of symptoms typify a number of common, chronic, disabling illnesses. To varying extents many patients report and/or demonstrate: i) Impaired mental capacities, including loss of short term memory, difficulties in verbal expression and/or comprehension, attention deficit and lethargy; ii) altered personality, including a reduced capacity to relate emotionally to others; iii) mood changes, including depression, anxiety and anger; iv) sleep disturbance; v) instability of autonomic nervous system regulation of blood pressure, pulse rate and/or bowel functions; vi)headaches and; vii) generalized body aches and pains. The medical community is split between those who view these symptoms as an indication of an underlying organic disease process, and those who consider the symptoms merely as an extension of the normal stresses and strains of everyday living."

Fibromyalgia & Chronic Fatigue Syndrome Sites

C F S - Information International Site has an extensive amount of information on FM & CFS. "Chronic fatigue syndrome following a toxic exposure

Chronic fatigue syndrome (CFS) is a clinical entity characterized by severe fatigue lasting more than 6 months and other well-defined symptoms. Even though in most CFS cases the etiology is still unknown, sometimes the mode of presentation of the illness implicates the exposure to chemical and/or food toxins as precipitating factors: ciguatera poisoning, sick building syndrome, Gulf War syndrome, exposure to organochlorine pesticides, etc. In the National Reference Center for CFS Study at the Department of Infectious Diseases of `G. D'Annunzio' University (Chieti) we examined five patients (three females and two males, mean age: 37.5 years) who developed the clinical features of CFS several months after the exposure to environmental toxic factors: ciguatera poisoning in two cases, and exposure to solvents in the other three cases. These patients were compared and contrasted with two sex- and age-matched subgroups of CFS patients without any history of exposure to toxins: the first subgroup consisted of patients with CFS onset following an EBV infection (post-infectious CFS), and the second of patients with a concurrent diagnosis of major depression. All subjects were investigated by clinical examination, neurophysiological and immunologic studies, and neuroendocrine tests. Patients exposed to toxic factors had disturbances of hypothalamic function similar to those in controls and, above all, showed more severe dysfunction of the immune system with an abnormal CD4/CD8 ratio, and in three of such cases with decreased levels of NK cells (CD56+). These findings may help in understanding the pathogenetic mechanisms involved in CFS.

All CFS subgroups showed low levels of serum magnesium in most of the patients. A similar algological profile with a characteristic reduction of only the muscle pain thresholds and normality of cutis and subcutis pain thresholds was documented in PV-CFS patients and in those with a toxic exposure, while MD-CFS patients showed a reduction of pain thresholds in all the body districts taken into consideration (cutis, subcutis and muscle) as well as a positivity of more than 11 tender points to support the existence in such patients of a concurrent fibromyalgia syndrome (FS). Furthermore, abnormal evoked auditory potentials were reported more frequently by MD-CFS patients than by the other two CFS subgroups.

The patients with a previous exposure to toxics had disturbances of hypothalamic functions similar to those determined in the other two subgroups: most of the patients showed low levels of DHEA-S, a normal profile of the circadian rhythm of the other examined neurohormones. Finally, an abnormal increase of prolactine levels followed the buspirone challenge test, to suggest an up-regulation of 5HT1A hypothalamic receptors in all the three subgroups of patients.

The only comparative analysis that underlined a different behavior of patients with a previous toxic exposure was the lymphocyte subsets characterization (Table 2). Patients with a history of toxic exposure in fact showed a more severe dysfunction of the immune system in a statistically significant way compared both to PV-CFS and MD-CFS patients, and specifically: an abnormal CD4/CD8 ratio; three of such five cases also showed decreased numbers of NK CD56+ cells.

Chronic fatigue syndrome (CFS) still remains of uncertain definition because of the lack of specific features both clinically and objectively. However, CFS patients complain of some alterations more recurrently than others, such as serum magnesium deficiency, muscle hyperalgesia, impaired activation of HPA axis. In our opinion, the study of the immune system status in CFS patients might help in a better characterization of the syndrome, even if more immunologic studies are required as suggested by literature data. (1) A better characterization of T CD8+ lymphocytes so to differentiate cytotoxic cells from the suppressor ones. In fact many researchers (Barker et al., 1994) report a predominant reduction of CD8+CD11b+ lymphocytes or T suppressor lymphocytes and this agrees with the theory of a persistent immune activation in CFS (Landay et al., 1991). (2) The determination in plasma and, if possible, in CSF of some cytokines frequently found increased in CFS subjects (Patarca and Vollmer): IL-1, IL-2, IL-6, TNF alpha and beta. Our preliminary findings confirm the presence of a dysfunction of the immune system in CFS patients with an history of toxic exposure previous to CFS onset: an abnormal CD4/CD8 ratio principally due to a reduction of T CD8+ lymphocytes; three of the five examined patients also showed decreased numbers of NK CD56+ cells. So CFS patients with a post-toxic exposure onset might represent a well defined CFS subgroup characterized by specific immune dysfunctions probably precipitated by the toxic exposure itself.

In conclusion, further immunologic studies are needed for a better understanding of the pathogenetic mechanisms involved in CFS, as well as for a better categorization of CFS patients by the immune status.

Table 2. Lymphocyte subsets characterization (mean p/m S.D.)
Patients (no.) Student's
T-CFS (5) PV-CFS (4) MD-CFS (5) t-test (P)
CD4 cell count cell/mm^3) 763 p/m 253 921 p/m 43 1113 p/m 173 n.s.
CD8 cell count cell/mm^3) 469 p/m 256 599 p/m 298 607 p/m 483 n.s.
CD56 cell count cell/mm^3) 65 p/m 21^* 197 p/m 110^* 289 p/m 132^* *<0.03
CD4/CD8 ratio 3.0 p/m 0.8^* 1.8 p/m 0.8^* 2.7 p/m 1.7 *<0.05

Orthostatic intolerance and chronic fatigue syndrome: New light on an old problem "Chronic fatigue is a prominent symptom in a variety of overlapping syndromes of circulatory dysfunction, the most notable examples of which are neurally mediated hypotension (NMH) and postural tachycardia syndrome (POTS). An early suggestion that such abnormalities were treatable causes of symptoms in what we now call chronic fatigue syndrome (CFS) was made in 1940 by Alexander MacLean and Edgar Allen.1 They described a group of patients who experienced excessive acceleration of the heart and hypotension after moving from the recumbent to the erect posture, usually associated with symptoms of orthostatic exhaustion, blurring of vision, weakness on exercise, and syncopal episodes. McLean and Allen attributed the tachycardia to a reduced venous return to the heart, in part because symptoms and hemodynamic changes could be provoked within 10 seconds by Flack's test, which involved forced expiration into a tube to maintain a mercury column at 40 mm, thereby reducing blood flow into the thorax.1,2 They concluded that this orthostatic tachycardia syndrome seemed similar to “effort syndrome, irritable heart, or neurocirculatory asthenia” the synonyms of the day for what we now call CFS. McLean and Allen reported that patients improved by increasing their intake of fluids and sodium, and by sleeping with the head of the bed elevated. The head-up bed may have helped to conserve intravascular volume by reducing blood flow to the kidney at night. It is a medical curiosity that these detailed observations were largely ignored for several decades."

National Fibromyalgia Association "To develop and execute programs dedicated to improving the quality of life for people with Fibromyalgia by increasing the awareness of the public, media, government and medical communities." Site has research/clinical trials, educational, support & activitist information & links.

Sick and so very tired Sufferers of chronic fatigue syndrome battle disabilities and misunderstanding "CFS can affect all age groups from any racial or socioeconomic background. It appears to carpet bomb the body's immune, nervous and endocrine systems. The all-out attack can produce a broad range of symptoms: aching muscles and joints, recurrent sore throat, swollen lymph glands, difficulty concentrating, poor memory, feverish feelings, headache, low blood pressure, irritable bowels, environmental sensitivities including hypersensitivity to sound and light, loss of appetite, muscle spasms, sleep disturbances, reactive depression to being chronically ill, and -- last but certainly not least -- mental and physical exhaustion so profound it can confine people to bed for months, even years." Artical shares people's stories as well as theories of etiology.
"In Belgium, Dr. Kenny De Meirleir and his colleagues have published several papers in peer-reviewed journals, though some work remains unpublished. He is working in an area of CFS research where there seems to be a widespread interest: the immune system. De Meirleir postulates that CFS begins when a virus invades the body, prompting the immune system to launch a defence. Part of that response is to activate an enzyme called RNase L that chews up viral invaders. Once the virus is expunged, RNase L activity should decline. But in patients who develop CFS, he says, it remains high, turning its damaging attention to cell-membrane proteins, affecting pain receptors, the intestinal lining and the blood-brain barrier that keeps harmful chemicals away from our grey matter. "We now have a complete understanding of the biology of CFS," De Meirleir tells Maclean's."

NATIONAL ME/FM ACTION NETWORK "a registered, charitable, non-profit organization dealing with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Fibromyalgia (ME/FM)--offering support, advocacy, education and research into the many, varied, anomalies connected with these illnesses. We work hand in hand with the General Public, Educators, Government Agencies, and the ME/FM Community to achieve these goals that are so important to sufferers under duress everywhere."

THE LATE EFFECTS OF ME Can they be distinguished from the Post-polio syndrome? "Few people would dispute that ME (Myalgic encephalomyelitis), an illness which blights the hopes and aspirations of all sufferers, especially the young, is denied equal treatment in respect of diagnostic facilities, medical coverage and welfare provision. Comparable chronic and unpredictably disabling neurological conditions, for example Multiple Sclerosis, which was formerly ascribed to "hysteria" and similarly neglected, now receive government recognition, facilities within the NHS, and more generous research funding - though the potential cost of effective treatment can still arouse bitter debate."

New Jersey Chronic Fatigue Syndrome & Fibromyalgia Center "The research division is dedicated to trying to determine the causes of Chronic Fatigue Syndrome and Fibromyalgia. Theories explaining these illnesses include viral infection, disordered cardiovascular function, and neurological factors. The research branch of our Center is testing these ideas. In addition, we are investigating whether mild exercise or physical conditioning will help decrease or reduce the symptoms of CFS. The Center is also pursuing several research trials to determine the effectiveness of medications of CFS and FM symptoms."

If you feel you have FM you may be interested in learning more. I got the following email from Carol Wallace, Ph.D. offering a FM online course.


I am a college professor who suffers from FMS. Currently I am offering an online course in coping with Fibromyalgia and was wondering if you would mind mentioning it to your readers.

Anyone who suffers from fibromyalgia is aware of the need to educate themselves about the beast that burdens them. Even more important is our need to interact with others who understand what we are going through and can share our experiences.

"Coping with Fibromyalgia" is an online course offered through's Suite University aimed at covering the basics of dealing with FMS, from diagnosis (and finding the right doctor) through coping with the physical and emotional aspects, traditional and alternative treatments, pitfalls of applying for disability and more. The course runs from May 27 through June 27. It includes 8 lessons with resources (including a link to your site), and a highly interactive discussion area for students and instructor to discuss the many aspects of FMS. There is a text, "Inside Fibromyalgia" by Dr. Mark Pellegrino as well as a large resource area for additional resources. For more information see

Carol Wallace

Virtually Gardening
Check our new Garden Center!

I normally don't promote products or books but found this email interesting in that she has found the cause of her symptoms, is getting the proper treatments which resulted in returned health & energy. Part of her problem was her thyroid.

Hi Linda

I have just found your site. I have been seriously ill with CFS for 8 years. I was housebound for 6 years. My husband became a full-time carer as I yo-yoed between being bedridden and being able to walk a few yards. So much of your site sounds familiar to me.

My symptoms were:
Permanent exhaustion
Brain wouldn't function
Sensitivity to cold
Severe muscle pains and twitchings
Abnormal heart rhythm
Sensitivity to noise
Painful joints
Loss of hair, eyelashes and eyebrows and dry hair
Numbness and tingling
Extreme sensitivity to the microwave, computer and telephone
Fluid retention
Sore tongue

It soon became apparent that the doctors did not know what was wrong with me so Colin, my husband and I set out on the long hard and very expensive journey, over £14,000, which was to find all the causes of my CFS.

My story has been exceedingly complicated but it turned out that I had several problems which were inter-linked.

I had thyroid malfunction. T3 and T4 levels were wrong. I am allergic to 50, yes 50, foods and have severe nutritional deficiencies because of the allergies.

I have been on treatment for all my symptoms for 3 years and I now lead an active life. I rarely sit down during the day.

Because so many people never find the cause of the ill-health I have written a book which is being reviewed very well by some magazines over in England. I have had 'phone calls from people who have bought my book to say that they have found it very helpful.

I have a web
If you would mention my site on your site I think that it could help many sufferers.

Heather Stott

The Scientific Basis for Understanding Pain in Fibromyalgia "Fibromyalgia is a clinical construct that has been developed, for the most part, by rheumatologists. It is a direct descendent of "fibrositis," a common misnomer (1) that was first coined in 1904 (2). There are always problems inherent in defining a disorder in purely descriptive terms. Nevertheless, the publication of the American College of Rheumatology's 1990 Classification Criteria for fibromyalgia(3) has been coincident with an impressive resurgence of research in this area. This article attempts to synthesize contemporary research findings."

American Chronic Pain Association "offering support and information for people with chronic pain.
What is Chronic Pain? "Pain that continues a month or more beyond the usual recovery period for an illness or injury or pain that goes on over months or years as a result of a chronic condition. It may be continuous or come and go.
A condition with high economic costs. It is estimated that US business and industry loses about $90 billion annually to sick time, reduced productivity, and direct medical and other benefit costs due to chronic pain among employees."

National Fibromyalgia Partnership, Inc. Site includes information, research, articals & other information on FM.

CFS/FM Support Group Sites

Managing My Fibro Managing My Fibromyalgia ... TIPS That May Help Fellow Sufferers "A wise man should consider that health is the greatest of human blessings, and learn how by his own thought to derive benefit from his illnesses." Bill shares his story & life living with FM. He has returned to work doing duties he can do & being productive in helping others as well.

Fibromyalgia Resource Center "The FMS PATIENT REGISTRY is seeking volunteers to participate in a research program that could significantly impact how FMS is diagnosed and treated. The goal — understanding the various factors associated with FMS and as a result developing better diagnostic and therapeutic tools.
You may also qualify to participate in the FMS GENOMICS RESEARCH program — an opportunity to help study the links between genetics and FMS."

Pediatric Network Fatigue Syndrome, Fibromyalgia and Orthostatic Intolerance "This is a gathering place for professionals, parents, children, teenagers, and young adults affected by juvenile fibromyalgia, pediatric chronic fatigue syndrome, neurally mediated hypotension, postural orthostatic tachycardia syndrome, and related conditions.
Please begin your research by visiting our resources page, where you'll find medical, educational, and parenting articles, along with youth essays and websites. You'll also find many links to organizations and support networks."

Northern Virginia Chronic Fatigue Syndrome & Fibromyalgia Support Group

SUPPORT GROUPS List of support groups.

Welcome To Your Fibromyalgia Community You can view the other FM websites or create your own. "The World's Largest Fibromyalgia & Chronic Fatigue Syndrome Website. 3,000+ Fibromyalgia & Chronic Fatigue Syndrome Articles & Abstracts · Fibromyalgia & Chronic Fatigue Syndrome Alternative Therapies."

Other Medical Conditions

ophthalmoplegic migraine "Ophthalmoplegic migraine is a rare form of migraine headache that is felt around the eye. It is often connected with weakness of the muscles around the eye.

What is going on in the body?
An ophthalmoplegic migraine causes severe headache. It also may affect the person's vision. The process that causes this type of migraine is not well understood. One possible cause is inflammation of the blood vessels around the eye. Allergic reactions are another possible cause.

What are the signs and symptoms of the condition?
A person who has ophthalmoplegic migraine has specific symptoms involving the eyes. These symptoms may differ from person to person but most likely include the following: · double vision · droopy eyelid, known as ptosis · eye paralysis · other types of vision changes · severe headache pain."

International Sleep Medicine Association The International Sleep Medicine Association is the first organization to link all people interested in sleep health and sleep disorders around the world. The goal of the association is to be a complete source for sleep information and communication for all people interested in sleep and sleep disorders."

North Carolina Chemical Injury Network Information pertaining to chemical sensitivities, FM and related conditions. Also includes activists and support information.

I included this site since perimenopause can cause "weird symptoms" that doctors may not consider especially if you are younger than 50 or look too young to consider perimenopause or onset of menopause.
MENOPAUSE "There are two types of menopause—surgical, in which a woman's uterus and/or ovaries are removed resulting in an abrupt cessation of menstruation, and natural menopause, a gradual process that probably begins when a woman is in her 30s as estrogen production begins to fall off. The hormonal changes culminating in menopause accelerate when a woman reaches her mid-40s. Medically, natural menopause is considered complete when a woman has not had a menstrual period for a year; this usually occurs between the ages of 48 and 55. In the United States, the average age of menopause is 52. Sometimes, however, a woman enters menopause in her early 40s, and at the other end of the age scale, a few women continue menstruating until their late 50s.

The age at which menopause will occur is difficult to predict. It is unrelated to menarche—the onset of menstruation— but there appears to be a genetic determination, because women tend to enter menopause at about the same age as their mothers, grandmothers, and other female relatives.

Menopausal symptoms vary considerably from one woman to another. Typically, however, irregular periods and other menstrual changes are the first obvious symptoms. In some women, periods become lighter and less frequent; in others, bleeding may be heavier, with two or three periods a few weeks apart, and then several months may elapse before another period.

At about this time, a woman may begin to experience hot flashes—a sudden rush of heat to her upper body, often followed by sweating and chills. Hot flashes are caused by vasomotor instability triggered by hormonal changes. About 75 to 80 percent of menopausal women experience at least occasional hot flashes, and in a few, they are so frequent or intense that they interfere with sleep and other normal activities (see Hot Flashes, later in this chapter). In most women, the hot flashes end within a few years of completion of menopause.

Other symptoms or changes associated with menopause include:
Vaginal dryness and itching. These changes usually appear several years after menopause and are marked by a shrinking of the external genitalia, thinning of the vaginal lining, and reduced vaginal secretions. Consequently, a woman may experience itching, increased susceptibility to vaginitis, and painful intercourse. In some instances, application of a vaginal cream or ointment alleviates the problem; in others, estrogen is needed (see Hormone Replacement Therapy).
Urinary Tract Symptoms. The urethra and urinary bladder are also susceptible to tissue thinning, resulting in increased vulnerability to cystitis. Older women, especially those who have had several children, also may experience stress incontinence and other bladder control problems.
Palpitations. Transient episodes of a rapid heart-beat are thought to be caused by the same vasomotor instability that produces hot flashes. Some women experience palpitations along with hot flashes, in others, they occur independently, and still others never have any. If palpitations become troublesome, a beta-blocker or another drug to steady the heartbeat may be prescribed.
Depression and Other Emotional Changes. Some menopausal women experience unexplained mood swings; others are unaccountably irritable, depressed, or forgetful. It is uncertain whether these psychological symptoms are directly related to menopause or to other circumstances that may coincide with menopause, such as the last child leaving home. Many researchers believe that a combination of hormonal and life-style factors are responsible.
Weight Gain. Many older women experience a redistribution of body fat, with an added accumulation around the abdomen—the so-called middle-age spread. Several factors may account for this. Energy needs decline with age, which can result in weight gain if the person does not reduce food intake or increase physical activity. A woman's increased levels of androgens (male sex hormones) promote abdominal fat deposits. Women who take replacement estrogen may gain weight. Finally, abdominal muscles weakened by repeated pregnancies and inactivity contribute to sagging and the appearance of abdominal weight gain."

Society for Neuroscience "Brain Briefings A series of two-page newsletters explaining how basic neuroscience discoveries lead to clinical applications."

I had read an artical on Parkinson's Disease several months ago & didn't realize there was more to Parkinson's Disease than the obvious involuntary mucle shaking and stiffness. If you want to learn more about what Mahamad Ali and Micheal J Fox, as well as others you may know who has Parkinson's Disease, is experiencing check the links to sites I got from the artical.

National Parkinson Foundation

Parkinson Association of Mecklenburg County

Worldwide Education and Awareness for Movement Disorders "The mission of is to probe health and medical scientific issues in a manner that one rarely encounters in mainstream news reports.
RFW will also feature columns and stories that encourage personal growth, particularly those that help individuals to fight against the various forms of tyranny all too common in daily life.
RFW will raise "red flags"or issues that require public attention and debate."